Lazy Boy Payments

Payment Form

Billing address

First name

Valid first name is required.

Last name

Valid last name is required.

Email

Please enter a valid email address.

Phone

Please enter a valid phone number.

Address

Please enter your shipping address.

Address 2 (Optional)

City

City required.

State

Please provide a valid state.

Zip

Zip code required.

Payment Location

Please Select Payment Location.

I agree to the terms and services

Payment

Invoice Number

Enter an Invoice Number

Customer Code

Enter an Invoice Number

Payment Amount Number and decimals only

Payment ammount

Credit card number

Credit card number is required

Expiration Month

Expiration date required

Expiration Year

Expiration date required

CVV

Security code required