Approved
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Amount:
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Card Number:
Authcode:
AVS Result:
CVV Result:
OK
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Khal Chassidim Of Bayswater
31-28 Westbourne Avenue • Queens, NY 11691
Personal Information
Full Name
*
Address
Zip code
Phone Number
Email Address
*
Transaction Details
$
Amount
*
Description
Credit Card Details
Pay with Check
Card Number
*
MMYY
*
CVV
?
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Merch Pay, Inc. is a registered ISO of Wells Fargo Bank, N.A., Concord, CA.
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Credit & Debit Processing | Electronic Check Services | Gift & Loyalty Programs | Customized POS Solutions
Khal Chassidim Of Bayswater
31-28 Westbourne Avenue
Queens, NY 11691
Tell: (305) 720 - 1827
[response]
ID #[transid]
[created]
[cardholder]
$ [amount]
[cardtype] [ccnum4]
Authorization Number
[authcode]
AVS Response
[avsresult]
CVV response
[cvcresult]
[otherTransaction]
