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PLC:

a001vd

Agency:

city of winfield

For:

court fines

Phone:

620-221-5500

Address:

200 east ninth,p. o. box 646
winfield, kansas 67156

*Required Field

Payment Information

*Defendant's Name:

Middle:

*Last:

*Defendant Date of Birth:

(Month / Day / Year)

Citation #:

Phone #:

(### - ### - ####)

Email Address:

Payment Amount

*Payment Type:

Payment Amount :

Subtotal:

$0.00

Total:

$0.00

Billing Information

*First Name:

Middle Initial:

*Last Name:

*Billing Address:

*City:

*State/Province:

*Zip:

*Country:

*Phone Number:

*Credit/Debit Card:

(enter the full card number without any dashes or spaces)

*Expiration Date:

*Card Security Number:

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