Pay by Check

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Important

Check Payment Instructions:

Fill out the next check from your checkbook, just as you would if you were actually mailing the check to our office.
Make the check payable to Integral Recoveries and date it with today’s date.
Write VOID on the check and keep it as your receipt.
All required form fields below are noted with an *

Recurring charge
authorization form

Click to download form

Payment plan
authorization form

Click to download form

Your Information as it appears on our statement

Pay by Check Form

Your Information as it appears on our statement

*Required

File Number*

Your Information

Name*

First Name Middle Initial Last Name

Address*

Address City State Zip

Home Phone Number*

Work Phone Number*

Check Information

Check Number*

$ Amount Paid*

Bank Information

Bank Name*

Routing Number*

Account Number*

Check Payment Instructions:

Recurring charge authorization form

Payment plan authorization form

Pay by Check Form

Pay by Check Form

Your Information

Check Information

Bank Information

Recurring charge
authorization form

Payment plan
authorization form