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Important Information

There is a 2.39% convenience fee for credit card payments, a 2.09% convenience fee for debit card payments. All convenience fees are non-refundable. ACH FAQ.

CHIA Data Request or Public Information Request

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Last Name

Phone Number

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Email Address

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General Information

Please enter the payment information for whom you are making a payment. This information must match the billing information that will be asked on the next page.

Enter Company OR First and Last Name below.

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Agent ID

SSID

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