Tribal Government Bill Credit Card Payment

Payment Details
*This information is required
Services You Wish To Pay For (Select All That Apply)*
- Ambulance Services
- Replacement Tribal ID Card
- Advertising (Website, Newspaper, TV Screens)
- Purchase of an Employee Time Card/Badge
Ambulance Services
For questions about your account contact 785-966-2164.
Patient Name*
First Last
Account Number*
Date of Service*
MM slash DD slash YYYY
Ambulance Service Payment Amount*
Replacement Tribal ID Card
Online payment for Replacement Tribal Identification Cards are only available for those who have previously been issued a card. If you have never received a Tribal ID, do not make payment through the portal, contact the department directly. For questions, contact 866-277-3722.
Tribal Member Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Tribal ID Card*
Price:
Advertising (Website, Newspaper, TV Screens)
For questions about your account contact 785-966-3920.
Client/Business Name*
Invoice Number*
Advertising Payment Amount*
Purchase of an Employee Time Card or Badge
For questions, contact 866-694-3937.
Employee Name*
First Last
Employee Time Card or Badge*
Billing Details
*This information is required
Contact Name*
First Last
Email*
Phone*
Billing Address*
Street Address Address Line 2 City State ZIP Code
Secure Credit Card

Card Holder*

Card Number*

Card Expiration*

Card CVV*
Convenience Fee
$0.00
Total
$0.00
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Payment Details