Bricks R Us | One-Time Payment

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All fields are required.
Your Customer ID
Purchase Order Number(s)
Amount	$
Credit Card Surcharge	—
Total Transaction Amount	—
This surcharge does not exceed our cost to process the transaction. To avoid paying this credit card surcharge, you can also pay via electronic check.
Card Type
Credit Card Number
Expiration Date
CVV2
First Name on Card
Last Name on Card
Statement Billing Address
Statement Billing City
Statement Billing State
Statement Billing ZIP Code
Billing Phone Number
E-Mail Address