Payment Method Change

Payment Method Change

Use this form to change a payment method associated with your existing Website Hosting and Maintenance Agreement.

Agreement Information

Client
Agreement ID

Change Ongoing Service Payment Method

Select the payment method you would like to use for future ongoing website service.

New Ongoing Service Payment Method

Automatic PayPal Payments

You are changing your ongoing-service payment method to automatic PayPal payments of $32.00 per month.

After submitting this change, instructions for establishing the new PayPal payment will be provided.

Quarterly Invoicing by Mail

You are changing your ongoing-service payment method to $110.97 every three months in advance.

Invoice and mailing instructions will be provided after submission.

Change Outstanding-Balance Payment Method

Select how you would like to pay the remaining outstanding balance.

New Outstanding Balance Payment Method

PayPal Outstanding-Balance Payment

You are changing the outstanding-balance payment method to PayPal.

Payment instructions will be provided after this change is submitted.

Mailing the Outstanding-Balance Payment

You are changing the outstanding-balance payment method to mail a check.

Invoice and mailing instructions will be provided after this change is submitted.

Payment Method Change

This change modifies only the payment method identified above. All other terms of the existing Website Hosting and Maintenance Agreement remain unchanged and in effect.

This payment-method change does not reopen, reinstate, or alter any charge that has already been paid.

Payment Method Change Authorization

Electronic Signature

Type your full legal name exactly as shown for the Authorized Representative on the existing Agreement.

By typing your name and submitting this form, you authorize this payment-method change and intend to sign it electronically.