Request receipt of payment
Submit an online request and we will reply as soon as we can, usually within 1-2 business days.
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After clicking in “Next”, you will be redirect to another page to add attachments and
submit the request.
Once submitted, you will see your case number on screen .
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First Name
*
Last Name
*
Email Address
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Phone Number(numerals only; no dashes)
*
Account Name
*
Account Number
*
Payment amount
*
Payment date
Payment method (Optional)
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Question or comment
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