| current_username | tytd | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| fname | Nivardo | ||||||||
| lname | Mora | ||||||||
| thecity | Miami | ||||||||
| thestate | Fl | ||||||||
| theemail | Email hidden; Javascript is required. | ||||||||
| thephone | (786) 510-9961 | ||||||||
| HTML Block | This is a new transaction for Nivardo Mora. | ||||||||
| HTML Block | Click the Green [Add Vehicle] button below to begin this registration. Multiple vehicles? Register them all now and pay Once! | ||||||||
| Items in this transaction: |
| ||||||||
| HTML Block | You can ⬆ add another vehicle, or enter your Credit Card info ⬇ and Submit This Registration. | ||||||||
| POLL (optional) | No, I'm a regular | ||||||||
| Transaction Total | $75.00 | ||||||||
| Items Subtotal | Items Subtotal, Qty: 1, Price: $75.00 | ||||||||
| dummy subtotal | 75 | ||||||||
| Credit Card | Visa XXXXXXXXXXXX6389 | ||||||||
| Approved? (Admin-only) |
|
