First Name*
Last Name*
Phone Number*
Email Address*
Company Name*
Company Website
English & SpanishEnglish Only
VisaMasterCardAmexDiscover
YesNo
Transfer Phone Number
Office Hours
Credit/Debit Card Fee Amount
Check/ACH Fee Amount
Minimum Amount Limit
Maximum Amount Limit
Account Number Minimum Length*
Account Number Maximum Length*
Example Account Number*
Greeting Message* Thank you for calling the (COMPANY NAME) Direct Pay Service. This service will allow you to make a one-time payment on your account using your Visa, MasterCard, American Express, Discover or Checking account. All payments entered will be processed today.Customize this sample message
Account Message* Please note, in order to access your account, you must have your (#) digit (NAME) account number located on the upper right corner of your letter you received. Please enter your (#) digit (NAME) account number now followed by the pound key.Customize this sample message
Goodbye Message* Thank you again for using the (NAME) Direct Pay Service. Goodbye.Customize this sample message
Error Message (if not transferring caller)* If you need to speak with a customer service representative, please contact our customer service department at (Phone Number) during the hours of (Time) to (Time) Monday through (Day).Customize this sample message
Additional Comments
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