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If you are making a payment for more than one policy, please complete this form and fax to GUA after credit card transaction is completed:
NOTE: We are still in the testing phase of accepting credit card payments. We will no longer be accepting payments from checking/savings accounts.
AGENTS: Please submit the net portion of premium only.
REQUIRED: For identification purposes, the following information must be provided: -“Invoice #” field : enter the policy # or “multiple” if submitting the multiple payment allocation form -“Description” field : enter the insured last name and address or “faxing multiple payment allocation form”
REMINDER: If you are making a payment for a renewal you must still provide the signed continuation of coverage form. Signed form can be faxed to (770) 717-8620 with a note stating that payment was made via credit card (include your transaction # on the faxed form)
Thank You. |