Trinity Billing Solutions

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* * Attention * * If you have any questions or would like to talk to a Specialist, please call Trinity Billing Solutions (also known as "Trinity") at 866-217-1674. Standard business hours: Monday thru Friday 8:00am to 5:00pm, Central Time. CREDIT CARD TRANSACTION By 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 Trinity, 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 Trinity. By clicking on the "Process Payment" button you are accepting these terms and any stated fees for using this service. Please remember to print this form for your records. CHECK TRANSACTION By submitting payment information, you are authorizing Trinity to reproduce this item as an 'ACH Transaction' for deposit on the date specified above. A transaction that is returned to Trinity for any reason is subject to a returned item fee by your banking institution and Trinity's bank. You authorize us to collect a fee of $25 through an electronic fund transfer from your account if your payment is returned unpaid. An ACH transaction will be produced utilizing the information from this form you are submitting. You also authorize subsequent attempts to clear this transaction if the orginal is dishonored or returned for any reason. By clicking on the "Process Payment" button you are accepting these terms and conditions and any stated fees for using this service. Please print a copy of this page for your records. I have read the information above and wish to make a payment.

* * Attention * *

If you have any questions or would like to talk to a Specialist, please call Trinity Billing Solutions (also known as "Trinity") at 866-217-1674. Standard business hours: Monday thru Friday 8:00am to 5:00pm, Central Time.

CREDIT CARD TRANSACTION

By 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 Trinity, 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 Trinity. By clicking on the "Process Payment" button you are accepting these terms and any stated fees for using this service. Please remember to print this form for your records.

CHECK TRANSACTION

By submitting payment information, you are authorizing Trinity to reproduce this item as an 'ACH Transaction' for deposit on the date specified above. A transaction that is returned to Trinity for any reason is subject to a returned item fee by your banking institution and Trinity's bank. You authorize us to collect a fee of $25 through an electronic fund transfer from your account if your payment is returned unpaid. An ACH transaction will be produced utilizing the information from this form you are submitting. You also authorize subsequent attempts to clear this transaction if the orginal is dishonored or returned for any reason. By clicking on the "Process Payment" button you are accepting these terms and conditions and any stated fees for using this service. Please print a copy of this page for your records.