AssurancePay® Recurring Payments

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.

Your bill account is currently being paid by Recurring Payments drawn from your bank account. From this screen you have options to modify your AssurancePay settings, or cancel your Assurance Pay recurring payments.

Submissions must be at least five (5) business days prior to the next draft date as shown on the Recurring Payment Schedule. Changes submitted may not take effect until the next billing cycle.

Acknowledge the statement below and click the Submit button to confirm removing Recurring Payments from your policy. Clicking Cancel will terminate your request and return you to the Account Summary screen.


              


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 a recurring payment schedule.

I am authorizing Texas Farm Bureau Insurance Companies to deduct my premium payments from the bank above. I understand that the original AssurancePay® Recurring Electronic Funds Transfer (EFT) Terms of Agreement are still in force in accordance with the original AssurancePay® Enrollment Form which I previously signed and that I must allow a reasonable time for processing this change.

I am authorizing Texas Farm Bureau Insurance Companies to remove my bill account from AssurancePay® Recurring Payments. I understand that I will be receiving billing statements and will be responsible for paying the amount due as stated on each statement. I understand that the original AssurancePay® Recurring Electronic Funds Transfer (EFT) Terms of Agreement are still in force in accordance with the original AssurancePay® Enrollment Form which I previously signed and that I must allow a reasonable time for processing this change.

     

AssurancePay® Recurring Payments must be setup at least five (5) business days prior to your next due date.

Any billed installments on your account will need to be paid before automatic drafting will begin.


AssurancePay® Recurring Payments change submissions will not take effect until your next billing cycle.

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If you prefer to use paper instead, please print out and return these documents by mail: