MAKE A PAYMENT

[[[["field34","contains"]],[["show_fields","field4,field5,field19,field17,field20,field28"]],"and"],[[["field33","contains"]],[["show_fields","field22,field36,field35"]],"and"]]
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MAKE A PAYMENT
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$0
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$5000
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$[ field4 + field5 + field22 ]


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