Make a Payment 1 Payment Information2 Payment Schedule3 Make Payment Advertiser Name / Corporate Name*Billboard NumberIf you have an billboard number, please enter here.Invoice Number or Notes About PaymentShould an invoice number or notes about payment not be supplied the payment will be applied to the oldest open invoice for your account.Additional Invoice Numbers or Notes About Payment, if necessaryIf you are paying more than one invoice, please add the additional ones here. Or let us know if you are paying for something specific like artwork or a new vinyl. Simply click the plus button to add another field. What Type Of Payment Will You Be Making?Credit CardCorporate CardACHName on the Credit Card* First Last Company Name on Credit Card*Option 1Option 2Billing Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Contact NameIf your name is different than the card holder's name, please enter your name here. First Last Email* Phone*Payment Options*One Time PaymentMonthly ReoccurringReoccuring Payment Duration*Please enter the quantity of months in your agreement that you are scheduling for payment.123456789101112Start Date* Amount*The amount due each period can be found in your Outdoor Advertising Agreement. Please enter a value greater than or equal to 50.What Are You Making A Payment For?* Rent Other * JGI charges a 2.89% fee for credit card processing. This fee will be added to your total payment, and would be applied to each payment if reoccurring.Total Amount($)Processing Fee(%) Payment Dates*Below is your payment schedule with JGI for the term of your agreement. Should you need to adjust any individual payments for any reason, you are able to adjust them in the date pickers below. Please note that if a payment falls on a weekend or bank holiday, it will be processed on the next business day. Also once this schedule is entered we will be unable to change it..Payment 1 Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name NameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.