Online Payment Request Form

Instructions:

1) Complete the fields shown below

2) Once complete, click the white "Send Request" button

3) Click "Close" to return to Member Services

Note: * required

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Complete Name:

You will receive an invoice in your email within along with instructions on how to make an online payment

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E-Mail Address

Membership Number:

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Mailing Address

E-Mail Address:

Street Address

City, State Zip Code

Close Form

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MM-Intro

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MM-Intro You are in the Member Services area of our website under thecategory of "Membership Information." Here you can check onvarious membership and billing related information.To proceed, simply select a subject from the menu to the left.

Membership Information - Introduction

MM-1 Adding or subtracting people from your plan or changing billing information is easy. Simply call our office or send us an email with the necessary changes; your account and bill will be adjusted appropriately. If needed, you will be sent a new membership kit as well. Normally the following people are eligible for family plans: A spouse Children up to the age of 18 (age 24 if they are a college student) Dependent SeniorsYou will need to provide each person's complete name and date of birth.

Membership Information - Information updates

MM-2 You can change your billing schedule by calling or emailing our office. Depending on when you contact us, your new billing schedule should go into effect before your next billing date. To be safe, allow three business days for your request to be processed. We offer a variety of billing options as well as discounts if you sign up for our automatic credit/debit card draft payment system. Your installment options are: Monthly You will receive a bill every month (not available with all plans) Quarterly You will receive a bill every three months Semi-Annually You will receive a bill every six months Annually You will receive a bill once per year (usually the most affordable)

Membership Information - Changing your billing schedule

Note: There are several billing options to choose from including paperless billing.

MM-4 You can obtain a new membership kit by calling or emailing our office. A new kit will be mailed to you containing a new membership agreement, a list of participating attorneys and other membership information. There is no charge for areplacement kit.

Membership Information - New membership kits

Note: Always review your membership kit and store it in a safe place.

MM-3 Help our environment and save a little money by going green with any of ourmany paperless billing options. You can choose to have your monthly, quarterly, semi-annual or annual membership automatically charged to any major creditor debit card. Also, if you select an automatic payment option, you willreceive a special discount with each installment.

Membership Information - Paperless billing options

Note: Special discounts for most automatic payment plans.

MM-7 For several security reasons, American Legal Services, Inc. doesnot provide your personal account information online. However, you can choose to pay your membership fee online simply by clicking the button below and providing the requested information. An invoice will be sent to the email address you provide which will allow you to pay your balance due online via credit or debit card or through Paypal.

Membership Information - Make a Payment

Online Payment

Request Form

MM-5 If you wish to cancel your membership, you must do so in writing either by email or regular mail. If you have recently received a bill you can write “cancel” on the bill and return it to our office. We cannot accept any verbal requests for cancellation. Additionally, as stated in your membership agreement, your membership is an annual agreement and can only be cancelled on your anniversary date. Installment payment options are a courtesy that has been provided to you and may not reflect your anniversary month. If you do not remember the month that you originally enrolled, simply contact our office.Please remember the following: 1) Your membership is an annual agreement. 2) Memberships can be cancelled each year on your anniversary date. 3) Be sure to contact us at least 30 days before your anniversary date.

Membership Info. - Canceling your membership

Remember: We must receive your cencallation at least 10 days before your anniversary date

Remember: You must contact us at least 30 days in advance if you wish to cancel.

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