Cashier - Payment Request  

We must manually process every payment. Use this form to request to make your regular monthly payment or any advance payments on your contract(s). You will receive confirmation the request was received, as well as confirmation the payment was processed. 

If this becomes too much of a hassle, Email Christi and ask her to set up Automatic Payments.

Parcel Code  Parcel Code example: Lorelei Trails Parcel Z = LT-Z 
Phone #  Number where you can be reached if we have a problem processing this payment.
Credit or ATM Card Type  MasterCard  VISA  Discover
Credit Card Number 
Expiration Date 

Amount  $ 

  Name on card

Billing address and zip code of card 

Special Instructions 

(not required for regular monthly payments) 


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Copyright 1998-2018 Ozark Land Company Inc.   Last revised: April 27, 2018