Texas Farm Bureau Insurance - Manage Account Bill

In order to enroll in Texas Farm Bureau Insurance Account Bill, please read the Terms and Conditions, then complete and submit this Authorization and Agreement for Account Bill. You must continue to pay any billing statements you receive by mail or email until your Account Bill application is completed and accepted and you receive your first Account Bill statement.

Enroll

Policy Type

Policy Number

Two or more policies must be selected

First Name

First name is required.

First name must be between 2 and 15 characters.

First name contains some invalid characters.

Last Name

Last name is required.

Last name must be between 2 and 20 characters.

Last name contains some invalid characters.

Address Line 1

Physical address is required.

Physical address must be between 2 and 250 characters.

Physical address contains some invalid characters.

Address Line 2

Physical address line 2 must be between 2 and 250 characters.

Physical address line 2 contains some invalid characters.

City

City is required.

City must be between 2 and 250 characters.

City contains some invalid characters.

State

State is required

County

County is required

Zip

Physical zip code is required.

Physical zip code must be 5 characters.

Physical zip code must be numeric.

Requested Payment Day

Would you like to sign up for AssurancePay®?

Yes

AssurancePay selection is required

Name on Bank Account

Name on the account is required

Name on the account must be between 4 and 60 characters

Bank Routing Number

Routing number is required

Routing number must be between 4 and 60 characters

Routing number format is invalid

Unable to locate associated bank

Bank Name

Bank Account Number

Account number is required

Account number must be between 4 and 60 characters

Re-enter Bank Account Number

Account number confirmation is required

Account number confirmation must be between 4 and 60 characters

Account numbers do not match

Type of Account

Checking

Savings

Bank account type is required

Please review the information below. Click the Submit button when you have verified the information captured is correct. If the information below is not correct, please click on the Modify button to revise. Clicking Cancel will terminate your request and return you to the Account Summary screen.

Policies to enroll:

Policy Type

Policy Number

First Name

Last Name

Address Line 1

Address Line 2

City

State

County

Zip

Requested Payment Day

Name on Bank Account

Bank Name

Bank Routing Number

Bank Account Number

Type of Account

I have read and agree to the Terms and Conditions for Account Bill. I authorize Texas Farm Bureau Mutual Insurance Company, Texas Farm Bureau Underwriters, Texas Farm Bureau Casualty Insurance Company, and/or Farm Bureau County Mutual Insurance Company of Texas (the "Companies", "us", or "we") to apply one payment to multiple policies of insurance. My one payment will be applied to premium owed on all of the policies I list above and any applicable fees, and may be applied to any delinquent Texas Farm Bureau membership dues, in accordance with the Terms and Conditions listed above.

Please accept the conditions.

I have read and agree to the Terms and Conditions for AssurancePay® Recurring Premium Payments via Electronic Funds Transfer (EFT.) I authorize the Texas Farm Bureau Underwriters, Texas Farm Bureau Casualty Insurance Company, Farm Bureau County Mutual Insurance Company of Texas, or Texas Farm Bureau Mutual Insurance Company, as the Companies issuing the policy described above, to initiate through the designated financial entity the appropriate entries to transfer premium payments. I understand I am responsible for paying any paper billings I may already have received or receive prior to receiving an Account Bill statement.

Please accept the conditions.

Manage Account Bill

Policies to enroll:

Your request for Account Bill has been submitted for processing.