Use this form if you would like to securely submit credit card information to Estima, for payment of an existing invoice, for an order submitted separately (by fax or email, for example), or to complete a purchase based on a pro forma invoice.

Just fill out the form below, and then click on "Submit Information" to send us the information. You should receive a confirming e-mail message within 1 business day of submitting the credit card information. See Ordering Information for general information on placing an order.

Invoice Number

Please enter the Invoice Number for which you are submitting payment. Enter "Pro Forma" if submitting payment on a quote or pro forma invoice. Enter "None" if neither applies (be sure to explain in the "Additional Information" field below).

Invoice Number

If you would like us to reference a Purchase Order number or other identifying code on the order, please enter it here:

P.O. Number

Please enter any additional information, instructions, or comments in this field:

Customer Name and Address Information:
First name:
Last name:
Business/Organization:
Department:
Phone: Fax:
Email:
Address, line 1:
Address, line 2:
City:
State/Province:
Zip/Postal Code:
Country:
Serial Number(s) to register (if any):
Billing Information (if different than Customer Information)
First name:
Last name:
Business/Organization:
Phone:
Email:
Billing Address, line 1:
Billing Address, line 2:
City:
State/Province:
Zip/Postal Code:
Country:
Shipping Information (if different than Customer Address)
First name:
Last name:
Business/Organization:
Phone:
Email:
Shipping Address, line 1:
Shipping Address, line 2:
City:
State/Province:
Zip/Postal Code:
Country:

Credit Card Information

Specify the type of credit card you will use, and enter the credit card account number and expiration date in the fields below.

Credit Card Type:

Credit Card Number
Expiration Date (mm/yy)
Security Code*
Amount to Pay:

*The "Security Code" is an extra set of numbers printed on your credit card. For American Express, the code is a 4 digit number on the front of the card. For other cards, the code is a 3 digit number printed on the back of the card (the regular credit card number, or the last 4 digits of that number may also appear on the back of the card--be sure to enter only the last 3 digits for the security code).

Please note: Software products may not be returned if the CD envelope has been opened. If you do need to return any items, please contact our Sales department for instructions and authorization.

If you prefer to pay by check or money order, you can fill out the rest of this form, print it out, and mail it to Estima along with your check. Printable PDF format order forms are also available--see ordering info for details.



Note: Please double-check your e-mail address to be sure you've entered it correctly.