ZigaForm version 5.5.1

Payment Form

QCS clients have the option to pay invoices, Gross Sales Assessments, or other certification-related fees online through our website via Authorize.Net.

Note: clients paying assessments online must still submit the Gross Sales Assessment Form to QCS. These can be submitted via physical mail, or via email, to accounts@qcsinfo.org:

Please make a note through the payment form, or via email to QCS, of what the payment is for (invoice number, renewal fee, assessment period such as P116, P216, etc.), and include your operation name and entity ID number if you have one.

Please contact the QCS office if further assistance is needed, at 352-377-0133.


First Name*
Last Name*
Email Address*
Payment Amount*
Client ID or New Client*
Company Name*
Billing Address*
Zip Code*
Service Type*
Service Type (if Other)
Payment Method*
Credit Card Number*
Expiration Date (MM/YY)*
Security Code*
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