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Bellingham Plumbing & Heating Inc.
Please print this page, fill out the fields below, and fax to 360-734-6611.
Thank you for your payment!
Name (as it appears on the invoice):___________________________________________
Invoice Number (in the top right-hand corner of the invoice:_________________________
Credit Card Type (We accept Visa, MasterCard, and Discover):_____________________
Name (as it appears on the credit card):________________________________________
Credit Card Number:________________________________________________________
Expiration Date:_______________ Security Code:___________
BILLING address:__________________________________________________________
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