Billing Solutions, Inc., Bill Paying Service, Glenview, IL

SSAE 16 Certified

SecurityMetrics for PCI Compliance, QSA, IDS, Penetration Testing, Forensics, and Vulnerability Assessment

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Check Verification Enrollment

* Step 1 Complete all fields and “Submit Form”
* Step 2 Upon Receipt we will email you your Access Number and PIN
* Step 3 Process your Check Verifications by dialing your access number, entering your PIN and selecting a Bank

Ia. COMPANY INFORMATION
Company Name:*  
Country:*
Address:*  
Address2:
City:*  
State:*
 
Zip:*
 
Main Phone Number:*  -  -  
Contact First Name:*  
Contact Last Name:*  
Contact E-Mail:*    
Contact Phone Number:*  -  -  

Ib. Billing Address
Invoice Email Address:*  
*Note: Invoices are emailed only. Please specify above in section 1b the email address you wish to have your invoices sent to.

Ic. YOUR NUMBERS
Please list all of YOUR phone numbers that will need access to the Check Verification platform:
(enter digits only)		   -  -  
  -  -  
  -  -  
  -  -  
  -  -  

II. PAYMENT / BILLING OPTIONS:
Option 1: Monthly Invoicing: All charges will be billed on a Monthly Basis:
   
(Payment due within 14 days of invoice.)

Option 2: To Pay By CREDIT CARD:
Payment type:


 
*Credit Card Charges will appear on your statement under "Billing Solutions, Inc.". Inquiries, call 1-888-801-0091.
Cardholder's Name:  
Credit Card Number:
- - -
 
Expiration Date (MM/YY):  /  
*Note: Invoices are emailed only. Please specify above in section 1b the email address you wish to have your invoices sent to.

III. TERMS AND CONDITIONS:
   
 
 
Note:* indicates required field  
 
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For questions regarding the process, please send an email to -[email protected]