ACH REQUEST

 

In order to enter a payment into this system, you must input the account information from
one of your current checks. This must be from a checking account.

Please Note:  You MUST NOT enter the account information from someone else's
checking account. You must enter information from your own checking account.
Entering information from someone else's account may be construed as fraud.

Agents must obtain approval from the premium finance company
if utilizing a premium finance company account for an ACH payment.

Bank Routing Number (nine digits including leading zeros)

Bank Account Number (up to seventeen digits)

Re-Enter Bank Account Number For Verification

Type of Account: Checking

Name on Check 

Dollar Amount of Payment

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

Policy Number  

Phone Number (including area code) 

Email Address

Your Name

Your Interest In Property

 

I (We) hereby authorize the Virginia Property Insurance Association, hereinafter called COMPANY, to initiate debit entries to my (our) Checking Account indicated above at the depository financial institution named above, hereinafter called DEPOSITORY, and to debit the same to such account. I (we) acknowledge that the originator of the ACH transaction to my (our) account must comply with the provisions of U.S. law.

Please note that payments will not be recorded on VPIA's system until 3:45 p.m. on the next business day.