Town of Flagler
Misc Payments
Choose A Device from the List Below
OR
Add a New Device ID
Workstation Name
DeviceID
Payment Information
1
Information
Purpose of Payment
Purpose of Payment is required.
2
Payment
Amount To Pay
Amount is required
Service Fee Amount
Total Amount
3
Credit Card Payment Type
Cardholder Information
4
Cardholder Name and Address
First Name
First Name is required.
Last Name
Last Name is required.
Address 1
Address 1 is required.
Address 2
City
City is required.
State
Your State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State is required
Zip / Postal Code
Zip/Postal Code is required.
Bank Account Information
5
Pay With Check
Routing Number
Routing Number is required.
Invalid Routing Number.
Account Number
Account Number is required.
Verify Account Number
Account Number 2 is required.
Account Numbers Must Match.
Bank Account Type
Account Type
Checking
Savings
Account type is required
Secure server
128-bit encryption
Pin Pad Display
Credit Card Information
5
Manually Enter Credit Card Information
Card Number
Card Number is required.
CCV
CVV is required.
3 or 4 digits.
Expiration Month
Exp. Month
1 - January
2 - February
3 - March
4 - April
5 - May
6 - June
7 - July
8 - August
9 - September
10 - October
11 - November
12 - December
Expiration Year
Exp. Year
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
Is this a Corporate or Business card?
Please Select
YES
NO
Please indicate corporate card yes or no.
Secure server
128-bit encryption
Credit Card Information
4
Swipe Credit Card
Secure server
128-bit encryption
Using your EMV terminal (
):
1. Choose LinkID =
2. Swipe or Insert Card
3. When finished, click the continue button below
Masked Card Number
Card Type
Expiration
First Name
First Name is required.
Last Name
Last Name is required.
Billing Zip
Billing Zip is required.
Is this a Corporate or Business card?
Please Select
YES
NO
Please indicate corporate card yes or no.
Payment Approved
Payment Details
Auth Code:
Transaction ID:
Reference ID:
:
:
:
:
:
Transaction Type:
Card Type:
Card Number:
ACH Account:
Name:
Amount:
:
Total Amount:
Controls
X_______________________________
Merchant Copy
X_______________________________
Customer Copy