PAY ON ACCOUNT

INSTRUCTIONS

Please fill out this form with the amount you’d like to pay on your account. Once you click “Submit” a member of our accounting department will receive your payment information and apply the payment to your Barbara/Jean account. For this reason, payments do not process immediately. Please allow 2-3 business days for the payment to post on your account.

Click here to review changes to the Customer Charge Agreement.

Name on Barbara/Jean Account

First Name

Last Name

Phone

(###)

###

####

Credit Card #

Expiration Date

CVV

Payment Amount

Name on Credit Card

First Name

Last Name

Billing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Message

Please leave a note if there's anything else we need to know.

PAY ON ACCOUNT

INSTRUCTIONS

BARBARA/JEAN | 7811 CANTRELL ROAD, LITTLE ROCK, ARKANSAS 72227

(501) 227-0054 | pay on account