If you would like Bristol South, Inc. to process the payment electronically for you, please complete this form.
Your name (required)
Your email (required)
Contact phone number (required)
Property unit Address (required)
Please select which you are paying for: 6d Certificate: N/A$100 - more than 2 weeks to closing$150 - Closing is less than 2 weeks/ 10 business days$200 - Closing is in 3 business days or less Questionnaire: N/A$150 - Fannie Mae 1076$100- Fannie Mae 1077$200 Bank Preferred$200 Bank Preferred" "$250 HUD-9991 single unit$500 FHA full project
Complete the section for the preferred payment method
Checking Account - $3.95Savings Account - $3.95Debit Card - 6.95%Credit Card - 7.95% Complete this section for Bank Transfer - $3.95 processing fee
Complete this section if using a checking or savings account: Name on Account
Bank Name
Routing Number
Bank account number If you do not want to enter your account number, please submit the form and call Jen (508-823-2300 x 2103) with the number.
Card Option - only complete if using a card
Card Number If you do not want to enter the card number, please complete the rest of the form, submit and call Jen (508-823-2300 x 2103) with the number.
Expiration: Month:--1-January2-February3-March4-April5-May6-June7-July8-August9-September10-October11-November12-December Year: CVV2:
Name on Card
Full Billing Address
Agree: I authorize Bristol South, Inc. to process this payment. (required)
