Quick Payment - Orion Capital Solutions

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Pay To: Orion Capital Solutions Amount: : : 000 Routing Number Account Number Check Number

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Please Verify Your Information

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BY CLICKING ON THE SUBMIT PAYMENT BUTTON, I AGREE TO THE TERMS AND CONDITIONS OF USING MY CREDIT OR DEBIT CARD AS A PAYMENT METHOD AND I AUTHORIZE Orion Capital Solutions TO PROCESS A CHARGE FOR THE DOLLAR AMOUNT ENTERED ABOVE.

I hereby authorize Orion Capital Solutions to debit my debit or credit card in the amount specified above as payment to my account with Orion Capital Solutions for a single account, which will be processed pursuant to the terms of Regulation E; Electronic Funds Transfers of the Federal Reserve System.

I hereby electronically consent to and authorize my signature to the funds transfer authorization. I also agree that I am authorized user of the credit or debit card account that I have provided and that I am authorized to make payment on this account.

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I Agree to the terms and conditions above