Clipboard with pencil checking boxes.

These are my sample instructions.
Adam's Second Payment Form
Used to contact you in case of problem with payment
Use cell phone if you wish to receive text messages
Dog - $1.00 Cat - $25.00 Fish - $0.50 Bird - $7.00
Gender (No notes) ($1.00) (No notes either) ($1.00) (Random notes)
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Payment method
Payment Details
Payment amount
Convenience Fee (Credit Card) 5.00% (of subtotal)
Note: a minimum charge of $1.00 will be applied.
Municipal Online Payments Fee (Credit Card) $1.00
Total
Announcement

Office Hours are Monday through Friday from 8am to 5pm.
Contact us
555-123-5555