Security Traders Association of Chicago

Invoice Information
Invoice Number	200001714	Customer Name	Natasha Solis
Invoice Date	10/30/2025 12:15:27 PM	Invoice Amount	$175.00
Balance Due	$175.00

Payment Information
Payment Amount *	$175.00
Payment Type*	ACH/E-Check (US banks only) Credit Card
Name on Card *	FIRST / M.I.	LAST
Card Type *
Card Number *
Card CVV Number *	(What is this?)
Exp. Date *	/
Account Type *
Account Number *	(confirm)
Bank Code *	(Routing Number)
E-mail Address *	PAYMENT RECEIPT WILL BE SENT TO THE ADDRESS YOU SPECIFY

Billing Information
Organization
Address *

City/Town *
Country *
State*	(Reset)
Postal Code *
Phone *

The Cardholder stated above has authorized this payment. If this payment is part of a recurring series of payments, the Cardholder understands the terms and amounts of those recurring payments, and authorizes payment for each of them. Cardholder consent will expire once all scheduled recurring payments have been processed, or if all future recurrences are cancelled. The Cardholder acknowledges that specific payment dates may vary. Examples include, but are not limited to: payment dates falling during weekends, holidays, or during system outages. In order to facilitate the processing of those recurring payments, stored credentials will be used. Those stored credentials will only be used to process payments that are part of this series of recurrences. In order to use those stored credentials for any other payment, Cardholder re-authorization will be required. In the event that a consent agreement must be modified, the new agreement will be sent to the email address associated with the invoice.

The Cardholder understands the terms and authorizes the payment(s).

SECURITY TRADERS ASSOCIATION OF CHICAGO