Form for LMR to set up a ClickPay account for you:

Name:*
Property Address:*
E-mail:*
Phone:*
-
Date to make payment:*
One Time or Reoccuring:*
FOR ONE TIME PAYMENTS, AMOUNT AUTHORIZED FOR DRAFTING
 $ 
For Reoccuring pmts - please draft on ______ day each month (between the 4th and 15th
Bank Routing Number (9 digits):*
Bank Account Number:*
Question / Concerns:

Once you click submit, it will be received by our office. We will confirm receipt and confirm the action has been completed within one day.

Please do not submit multiple forms. Thank you!