Auto-Pay Plan Enrollment Form
Number:
STEP 1 of 4: Are you enrolling in Auto-Pay or updating an existing account?
STEP 2 of 4: What Account Type should this change be applied to?
STEP 3 of 4: Which Payment Type would you like to apply to your Auto-Pay account?

IMPORTANT: What if I am past due on a payment?

If you have a past due payment, your Auto-Pay date will be advanced to your next scheduled due date. To ensure that your account remains in good standing, please make sure to pay any previous amounts due by using your statement or our Online Payment option.

IMPORTANT: What if I am past due on a payment?
If you currently owe for a payment more than 10 days past due:
  • Please pay any previous amount and remit envelope or by using our Online Payment option.
  • Any updates to your Auto-Pay will NOT satisfy the current amount due because Your Auto-Pay date will be advanced to your next scheduled due date.
If you currently owe for a payment 10 days or less past due:
  • Proceed with your Auto-Pay updates and your payment will be deducted once the new checking or savings account has been updated in our system (normally 1-2 business days).
  • Please note your subsequent payments will be deducted on their regularly scheduled dates.
Enter your Bank Account information below:
* Denotes a required field
Account Type *:
Routing Number *:
Bank Account Number *:
Re-enter Bank Account
Number *:
Name on Account *:
Bank Name *:
Bank City:
Bank State:
Bank Zip:
If your checking or savings account is with a foreign bank, we would be glad to assist you setting automatic payment with a credit card.
Enter your Credit Card account information below:
Sorry, Discover cannot be used for Canadian-based accounts at this time.
All fields required.
Credit Card Type:
  
Credit Card Number:
Re-enter Card Number:
Expiration Date:
  
Name on Account:
STEP 4 of 4: Auto-Pay Terms Agreement and Verification
I agree with the terms of the Autopay agreement as described below. My selection of this check box constitutes an eletronic signature.

ARE YOU HUMAN?
Why do we do this?