office (937)
222-2822
fax (937) 222-6468
toll-free (800) 766-4264
Commercial Accounts
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Download an application for payment by Credit Card by
Please complete the form, print, and sign, and securely fax the completed form back to us at 937-222-6468.
While you can email it to us, we recommend against that as your credit card information will not be secure.
If a fax is not available, you may want to drop it off at our office instead.