American Exchange Loans  
 
American Exchange Loans On-Line Automatic Recurring Bill Payment Form. All Fields are required.
 
Account Number A value is required.Invalid format.Minimum number of characters not met.Exceeded maximum number of characters.
Last 6 Numbers/Letters of VIN A value is required.Minimum number of characters not met.Exceeded maximum number of characters.
 
Personal Information  
First Name
Last Name
Address
City
State
Zip Code
Phone Number NOTE: Only use numbers, no dashes. Example: 9085551212.
 
Payment Schedule Information  
Scheduled Payment Occurrence NOTE: Type the number 1 in the field.
Scheduled Payment Unit NOTE: Units occur monthly, type months in the field.
Scheduled Start Date NOTE: Use YYYY-MM-DD format. Example: 2015-02-18.
NOTE: Start date MUST be on or before your regular payment due date.
Total Scheduled Payments NOTE: Total number of times the payments should be taken.
 
Credit Card Information  
Card Type
Credit Card Number
Expiration Date (YYYY-MM) NOTE: Use YYYY-MM format. Example: 2015-02.
Card Holder First Name
Card Holder Last Name
Credit Verification Code NOTE: 3 digits printed on the back of the card on the signature strip.
Payment Amount NOTE: Must use a decimal point but no dollar sign. Example: 900.00
*Processing Charge NOTE: A 4% Processing Fee will be added to the amount being paid.
TOTAL
 
 
 
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