Payment Request

PAYMENT REQUEST FORM

This form is intended for approved vendors and educators of Salon Xtensions. Please complete and submit the form below to request payment for services rendered or invoices due.

All payment requests are reviewed and verified by our Accounting Department before processing. Payments may take up to 14 business days to process once the completed form has been received and approved.

Submitting a fully completed form ensures timely review and helps us maintain an accurate and efficient payment cycle.

"The World's Healthiest Hair Extensions"

Vendor payment request

Submit your payment information to receive payment

Vendor name *

Email address *

Phone number *

Reason for payment *

Invoice number *

Payment amount *

Payment method *

ACH payment details

Account type *

Name on account *

Routing number *

9-digit routing number

Account number *

Zelle payment details

Zelle phone number *

Phone number registered with Zelle

Name on Zelle account *

Additional notes