Southern Connector - Pledge Payment Form

"Pledge to Pay" Toll Due
Online Payment Form

If you have completed a "Pledge to Pay Toll" form at one
of our toll plazas we offer this convenient, secure, online payment method to satisfy your obligation with your credit card.

The data you submit is transmitted electronically to our offices for processing on the next business day.

Please be sure you enter the pledge number and full amount of the toll due as specified on the copy of the pledge you received. (see illustration at right)

Then simply fill-in your credit card information and click "Submit". We accept Visa, MasterCard, American Express, and Discover. That's all there is to it. Thank you for using
our online system!

	Pledge Information:	Please enter the pledge number and issuant name EXACTLY as it appears on your notice. Incorrect entries may delay or negate your payment. The Southern Connector is not responsible for entry errors.
	Enter Pledge Number:
	Enter Issuant's Name Shown on Mailed Pledge Form:

	Payment Information:	You must complete this entire section to pay your pledge. By doing so you authorize the Southern Connector to charge your credit card in the amount you specified on this form. The charge will appear on your card statement as "CONNECTOR 2000 ASSOCIATION".
	Enter Payment Amt:	(Please remit entire TOLL DUE. No partial payments.)
	Enter Card Type:
	Enter Card Number:
	Enter Name on Card:
	Enter Expiration Date:
	Enter Card Security Code:	What's this?
		Note: Hitting your "back" button will reset this form. If you make an error, please scroll up to correct your mistake and re-submit.