Forms

Download and email, mail, or fax completed forms to the address or number below. In order to view PDF documents, you will need to have the free Adobe Acrobat Reader software installed on your computer. Download Adobe Acrobat Reader.

  AUTHORIZATION AND CONSENT TO ELECTRONIC COMMUNICATION (841k, PDF)

Please print form and fill out completely.

  AUTOMATIC PAYMENT (479k, PDF)

CUSTOMER AUTHORIZATION AGREEMENT FOR PREAUTHORIZED PAYMENTS

Please print form and fill out completely. ACH cannot be implemented without your signature. Include a voided check.

  PAYOFF REQUEST (62k, PDF)

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  CONFIDENTIAL FINANCIAL STATEMENT (56k, PDF)

Please print form and fill out completely.

  LETTER OF AUTHORIZATION (12k, PDF)

Please print form and fill out completely.

  COLORADO CHECK BY PHONE AUTHORIZATION (815k, PDF)

Please print form and fill out completely.

  AUTHORIZATION FOR ELECTRONIC STATEMENTS (841k, PDF)

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Please return completed forms to: 

FAX: 972.661.3748

Mailing Address:
Dyck-O’Neal, Inc.
Attn: Payment Processing
PO Box 650634
Dallas, Texas 75265

Have Questions?
Contact Us

Call Us: 800.447.2481

Para Asistencia en Español marque 800.447.2481 ext 2310