Secure Payment Form - Summersville Water Department

Summersville Water Payment Form

All information can be chnaged (including the amount to pay). The transaction will be confirmed ONLINE and by email (email address required).

Account No.: Amount:
GENERAL INFORMATION
(As Shown On Your Credit Card Statement. Your Address Will Be Verified.)

Full Name:
Address:
City:	State: Zip:
Country:
Phone Number:
E-Mail Address:

CREDIT CARD INFORMATION

Card Number:	Exp. Date:		(MMYY) i.e 0403
	Cards Accepted

If the credit card holder (above) is not the name listed on the water bill account, please enter the account information here.

Full Name:
Address:
City:	State: Zip:
Country:

Submit this form only ONCE.
Your credit card information will be processed in real-time. You should receive a response in about 2 seconds. However, if Internet traffic is unusually high, the transaction could take longer than usual. Pressing the submit button multiple times will cause multiple charges to your credit card account.