<h2>Set Up Payment</h2>
            <p>Use this form to authorize Cal Interpreting &amp; Translations (CIT) to accept your credit card payment(s).</p>
            <h3>Credit Card Authorization</h3>
            
                <ul id="gform_fields_8" class="gform_fields top_label form_sublabel_above description_above"><li id="field_8_2">Name*
                    First
                    
                    Last
                    
                </li><li id="field_8_3">Company Name </li><li id="field_8_1">Billing Address*
                    Street Address
                    
                    Address Line 2
                    
                    City
                    
                    State
                    AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific
                    ZIP Code
                    
                    
                </li><li id="field_8_4">Phone</li><li id="field_8_5">Email*
                    Enter Email
                    
                    Confirm Email
                    
                </li><li id="field_8_6">Service Requested*Translation/TranscriptionOnsite InterpretingOnsite Interpreting and Equipment Rental</li><li id="field_8_7">PO Number*The PO number is the first 5 numerical digits found on the subject title of the assignment information email.  </li><li id="field_8_8">Payment Type*Credit CardE-Check</li><li id="field_8_9">Card Number (no spaces)* </li><li id="field_8_10">Security Code / CVV* </li><li id="field_8_25">Expiration Date*MM/YY </li><li id="field_8_16">Name of Financial Institution* </li><li id="field_8_15">Account Number* </li><li id="field_8_14">Routing Number* </li><li id="field_8_21">Total Amount*</li><li id="field_8_26"><strong>Need a copy of our W-9?</strong><br /><a style="color:#3ab0db;font-weight:bold;" href="http://calinterpreting.com/wp-content/uploads/2019/05/CIT-W9-2019.pdf" target="_blank" rel="noreferrer noopener">Click here to download it</a></li><li id="field_8_19">Comments</li><li id="field_8_22">CAPTCHA</li><li id="field_8_24">Terms: Client authorizes CIT to charge the credit card/account for the full amount, plus a 3% credit card processing fee immediately after the completion of the assignment. If you would like to avoid the 3% credit card processing fee, please choose E-check for the payment option.*<ul class="gfield_checkbox" id="input_8_24"><li class="gchoice gchoice_8_24_1">
                    
                    I Agree
                </li></ul></li></ul>