Online Payment or Autopay Sign Up

Thank you for being a valued Webformix Customer. In order to minimize credit card processing fees Webformix has chosen to use a batch electronic payment processor, and we only process once per week on Fridays. This means that:

  1. When you turn in a one time payment it does not immediately process, it is added to the weekly batch which will be turned in to the processor on Thursday to run on Friday.
  2. Charges from Webformix will appear on your bank or credit card statement labeled as "APS (or Automated Payment Systems), Sandy UT".

Payment submitted now will be processed on Friday, October 18

Thank you for your interest in signing up for Webformix's Autopay service. In order to minimize credit card processing fees Webformix has chosen to use a batch electronic payment processor, and we only process once per week on Fridays. This means that when you sign up for our autopay service:

  1. Your invoice will still have the same due date, and will be emailed to you 1 day before it is due. We will then automatically process a payment for you on the Friday on or after that date. Your payment will never process before your invoice date, but may sometimes process up to 6 days later.
  2. Charges from Webformix will appear on your bank or credit card statement labeled as "APS (or Automated Payment Systems), Sandy UT".

Fields marked with a * are required

* Name as it appears on
your Webformix invoice:
* Mobile/Daytime Phone:
* Email:
* Retype Email:
* Amount to pay: $ One time payment
* Agree to autopay amount conditions: I confirm that I understand that Webformix processes electronic payments every Friday, which means that IF my account has a balance and it's a Friday, a payment will be initiated on my behalf, for the full amount of my current balance.
* Payment Method:

Webformix charges a 3% fee to process credit and debit card transactions.

In order to avoid this fee, we encourage customers to use the EFT (electronic funds transfer) option by providing a routing and checking account number with which we will process an electronic check on your behalf. Alternatively, you can always mail checks or money orders to our office at 204 NW 4TH ST GRANTS PASS, OR 97526-2014.

Credit Card Number:
Expiration Date: /
Billing Zip Code (5 digits only):
— or —
Bank Account Number:
Bank Routing Number:
* Name as it appears on
your Credit Card:
* Autopay Electronic Signature: I authorize and request Webformix to initiate debit entries to my account, by and through Automated Payment Systems, hereinafter called APS, and to debit the same to such account as indicated below at the depository financial institution indicated below. This authorization is to remain in full force and effect until Webformix has received notification from me of its termination in such time and manner as to afford Webformix and the depository financial institution a reasonable opportunity to act on it.

I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.

By checking this box, I am electronically signing my application. I understand that my IP address 3.228.21.186 is being logged.

Please fill out the Additional Comments section if there are any other important details for this payment.
Additional comments:
* Spam blocker:
Type the word INTERNET into the field below.
Phone: 541-474-6082
Fax: 541-385-8643
Email: sales@webformix.com
billing@webformix.com
gpsupport@webformix.com
[logo]Webformix
204 NW 4TH ST
GRANTS PASS, OR 97526-2014
Support Hours: 9am-5pm M-F
SAT & SUN: noon-5pm