Payment arrangement online formIdentification* First name Last name Phone number*Email* Email Confirm email Type of payment* Pay my balance Make regular paymentsPayment method* Pre-authorized payments Wire transfers Credit cardChoose between simplified / pre-authorized payments or start making regular wire transfers. In all cases, specify how often you will make your payments.Void check/PAD* Drop files here or Select filesMax. file size: 128 MB.Payment amount* $ 20.00 $ 50.00 $ 100.00 $ 150.00 OtherMake sure you are able to pay that amountOther amount* payment frequency*WeeklyBiweeklyMonthlyChose payment frequencyFirst payment date* DD slash MM slash YYYY ** Please note that if you have chosen the "pay my balance" field, it will not be a recurring payment **
