State Seal

FOR ELECTIONS ONLY
Credit Card Payment Transmittal Form
[All fields on form are required.]


[description of what payment is for – e.g. name of filing this form is attached to]


[enter name exactly as it appears on credit card]


[city][state][zip code]

/

All fields on the transmittal form are required. Your payment cannot be processed if all fields are not complete.

Note: In accordance with the contract between the State of Idaho and our service provider Access Idaho, a $1 non-refundable fee is added to each transaction. The Secretary of State's office does not keep any part of this fee.

Privacy Notice: This form is used to process your credit card payment for a filing or service with the Idaho Secretary of State's office. Your credit card information is NOT retained in our office. The information you enter on this page is not sent or saved anywhere. The printed form that you send to us is shredded after your filing or service request is processed.

Email to: [email protected]