Home Our City Departments Finance Accounts Receivable Health Permit Payment Health Permit Payment Edit Form CITY OF DUMAS HEALTH PERMIT PAYMENT Business Name* Invoice Number Contact Name Business Address Billing Address* Business Phone* If you would like to pay your your invoice by credit or debit card, please fill out the information below. We will then run the card at City Hall and have your receipt available there or email you a receipt if you input your email address below. Email Address Full Name on Credit Card Credit Card Type Visa Mastercard AMEX Discover Credit Card Number Expiration Date Security Code (Three Digits on Back of Card)? Billing Zipcode for Card BY CLICKING THE SUBMIT BUTTON, I AM AUTHORIZING THE CITY OF DUMAS TO CHARGE IMMEDIATELY TO MY CREDIT CARD THE AMOUNT ON THE INVOICE # ABOVE. Signature*? Date Field*