6800 Jericho Turnpike,
Suite 113E,
Syosset NY 11791
(800) 851 - 9592

Slide 1

Electronic Funds Transfer

 

If you wish to pay the Balance In Full or take advantage of the Settlement offered in your Collection Notice (if a Settlement is currently available), please update the appropriate amount in the Initial Payment field.

$
- - Select Day - Month - Year

If the additional Payment options do not apply due to a Payment in full please enter the Initial Payment date and $0.00 in the additional Payment options.

$
- - Select Day - Month - Year
$
- - Select Day - Month - Year
$
- - Select Day - Month - Year
$
- - Select Day - Month - Year
$
- - Select Day - Month - Year

Please choose the applicable Payment Schedule to repay the remaining balance of this account.

(If currently offered in your collection notice)
$
on the
and the of each month.

Contact Information:

(Last Four Digits)
()

Banking Information:

*- Field is required
· Note: If you enter an amount less than the full amount currently due, further collection efforts may occur on the remaining balance unless a previous repayment arrangement has been entered into with our office.