JMM Payment

If new client, write "New."

Do not use commas.

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Name:

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Phone:

ACH Amount:

Invoice #:

Client Matter #:

To finalize, please enter your payment details below:

Payment Method *

ACH / E-Check (Preferred method of payment) Credit Card (3% surcharge will be applied to all credit card transactions)

Bank Account Type *

Checking Savings

Checking Account Type

Personal Business

Billing Information

I authorize Jeffer Mangels & Mitchell LLP to charge my bank account or credit card for the total amount listed above.

Contact Robert Martinez
Accounts Receivable Department

Jeffer Mangels & Mitchell LLP
1900 Avenue of the Stars 7th Floor
Los Angeles, CA 90067

Phone: 310.785.5355

Email: RMartinez@jeffer.com