Please fill out each of the fields on this screen.  Once you press the button at the bottom of
the screen, you will be linked to a secure site at VeriSign to input your credit or check card
information.  After you provide VeriSign with the data they request, you will be sent back
to the Virginia Property Insurance Association Home Page.  You will receive e-mail
confirmation of your transaction after your payment is approved by VeriSign.


Credit Card Billing Address 

City    State    Zip Code 

E-Mail Address   

Phone Number   Fax Number

Prefix    Policy Number   Suffix 

The policy number is the 0 plus the six digit number
immediately following the "DF' or "CSF".

Amount of Payment