hsi-first | Hari Smruti International, Inc.

CARD PAYPAL BANK TRANSFER

Card Number

MM / YY

CVC Code

The 3-4 digits on the back of your credit card

Billing ZIP Code

Enter the Zip/Postal code for your credit card billing address

By clicking Donate, you authorise NONPROFIT ORGANIZATION to debit the bank account that you connect to for any amount owed for charges arising from your use of NONPROFIT ORGANIZATION’ services and/or purchase of products from NONPROFIT ORGANIZATION, pursuant to NONPROFIT ORGANIZATION’ website and terms, until this authorisation is revoked. You may amend or cancel this authorisation at any time by providing notice to NONPROFIT ORGANIZATION with 30 (thirty) days notice.

If you use NONPROFIT ORGANIZATION’ services or purchase additional products periodically pursuant to NONPROFIT ORGANIZATION’ terms, you authorise NONPROFIT ORGANIZATION to debit your bank account periodically. Payments that fall outside the regular debits authorised above will only be debited after your authorisation is obtained.

Bank Name

Account Type

Account Last 4

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