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Use this form to add authorized payment methods to your dealer account.If you do not wish to use either method, you can still email checks to [email protected] as an instant method of payment.
Information is stored via double encryption key and can only be accessed by authorized users.
Credit cards can be used for parts orders with no fee or for table orders with a 2.65% fee.ACH can be used for table orders with no fee. ACH method cannot be used for parts orders.
By signing this form I authorize Hill Laboratories to charge this credit card for , including shipping costs. I understand that I can contact Hill Laboratories at any time to update or remove my card information.
You cannot authorize a credit card for table orders and also authorize ACH payments for table orders. Only one payment method per order type can be authorized for automatic use. Please remove the table order credit card authorization if you wish to use ACH auto debit for table orders.
By signing this form I authorize Hill Laboratories to automatically debit my account for table order payments. I understand that I can contact Hill Laboratories at any time to update or remove my ACH information.
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