Customer Account Information:
By clicking the submit payment button I authorize PayGov to debit the bank account indicated on this web form for the noted amount and effective date.
I understand this debit may post to my bank account as soon as the effective date.
I understand that in the event this ACH transaction is returned by my financial institution, I may be subject to a returned item fee.
I understand Paygov must be notified on the effective date by 4:pm EST at 1-866-480-8552 in order to cancel this payment.