Diversion Program Online Payment
Name
*
First Name
Middle Name
Last Name
Court Case Number
Ex. CM1343-TR2022000000
Enter Case Number as Listed on Case Paperwork
*
Do you have more than one case number?
Yes
No
If yes, please type any additional case numbers as they are listed on your paperwork:
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Amount Due
*
$350.00
I understand that for the convenience of paying online, there is a processing fee of 3% plus .31 cents, charged by the online payment vendor. I know that to avoid the online processing fees, I can pay in person at 201 S Cortez St in Prescott, at the Utility Billing window. The total amount that will be charged to my credit card will be $360.81.
By checking the box to the right you agree to accept the processing charges as stated above.
*
I Understand and Agree to Accept the Charges as Stated Above
Signature
I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.
Total
*
prev
next
( X )
Diversion Program Fee + Processing Fee
$360.81
$
360.81
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Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
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Expiration Month
Expiration Year
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