Approved
Name:
Amount:
Card Type:
Card Number:
Authcode:
AVS Result:
CVV Result:
OK
OK
Cancel
Khal Sasregen - Sokolov
1279 E 24th St • Brooklyn, NY 11210
Personal Information
Full Name
*
Address
*
Zip code
*
Phone Number
Email Address
*
Transaction Details
$
Amount
*
Choose Destination
Membership/Seats
Bedek Habayis
Melave Malka
General Donation
Kollel
Hachnosas Kallah Fund
Maos Chittim
Other
Comments
Repeated Payments
Ongoing
2 Months
3 Months
4 Months
5 Months
6 Months
8 Months
10 Months
12 Months
18 Months
24 Months
36 Months
Credit Card Details
Pay with Check
Card Number
*
MMYY
*
CVV
?
Process Payment
Processing By
Merch Pay, Inc. is a registered ISO of Wells Fargo Bank, N.A., Concord, CA.
merchant login
merchant login
merchant login
merchant login
Credit & Debit Processing | Electronic Check Services | Gift & Loyalty Programs | Customized POS Solutions
Khal Sasregen - Sokolov
1279 E 24th St
Brooklyn, NY 11210
Tell: 718-338-1532
[response]
ID #[transid]
[created]
[cardholder]
[amount]
[cardtype] [ccnum4]
Authorization Number
[authcode]
AVS Response
[avsresult]
CVV response
[cvcresult]