Make a Payment

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This field is for validation purposes and should be left unchanged.

Notice: Element 74 recently updated this Authorization form.

Method Of Payment*

Invoice Number*

Invoice Amount*

Multiple Invoices

I have more than one invoice to pay

Recurring Transaction

This is a recurring payment

Would you like a paid invoice receipt?

I would like a receipt for this payment

When would you like to receive future invoices?*

Before Payment

After Payment

2nd Invoice Number*

2nd Invoice Amount*

Your Name*

First Last

Company Name*

Payer's Email*

Address*

Street Address Address Line 2 City State ZIP Code

Credit Card*

A 3% convenience fee applies to payments made by credit card, debit card, or Google Pay.

Convenience Fee

$0.00

Total

Account Type*

Account Holder's Name*

Routing Number*

Confirm Routing Number*

Account Number*

Confirm Account Number*

Select a date to process the payment*

Payment Amount