Biller Payment Automation Enrollment

Enrollment

Required fields are denoted like this.

Please provide the following information:

Organization name:
First name:
Last name:
E-mail address:
Phone number:  -  - 
Extension:

Estimate the number of payments you receive from FIS each month:
Do you receive electronic payments today?
Yes
No
If you receive electronic payments,
check all sources that apply.
Financial Institution (ACH-CIE)
Financial Institution (CTX EDI 820 Version)
ORCC/Princeton eCom
MasterCard RPPS
Visa ePay
Other
(If "Other," please provide the name of your payment source. If you have more than one, enter the names separated by a comma.)