Account Number will be referenced on your billing
Incorrect or partial account number may cause delay or denial
If you selected 'Yes' be sure to enter a valid email
address below in order to recieve a payment confirmation.
You must be authorized to sign the check. By selecting 'Yes' and submitting payment information through this Service you agree to the terms and conditions of this Agreement and any documents incorporated by reference. You further agree that this User Agreement forms a legally binding contract between you and AR Billing Services and that this Agreement constitutes "a writing signed by You" under any applicable law or regulation. Any rights not expressly granted herein are reserved by
AR Billing Services.
By selecting 'Yes" and 'Submit Paymnet' I understand that
my check will be presented to my bank electronically.
After you Submit Payment the check will be submitted to AR
Billing Services and you will not be able to make changes without
contacting AR Billing Services. I understand unless prohibited by State
law or statute a return check fee of $30.00 will be
charged to your account for not sufficent funds (NSF).
Please save or print this authorization for your records.
Please verify all information before submitting your payment. Incorrect account information can cause denial or delay of payment. Refunds will be automatically submitted on over-payments by mailing a paper check. If you need to cancel
a current payment arrangement or put a stop on a recent payment please contact the billing department for immediate assistance (877)
879-6613. Older versions of Internet Explorer may expereince issues with use of this form,
we recommend using the most recent version of Google Chome.
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