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PLC:

a002ce

Agency:

city of leola

For:

water, sewer, & project fee payments

Phone:

605-439-3299

Address:

742 sherman st
leola, south dakota 57456

*Required Field

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*Name:

Middle:

*Last:

*Account #1:

* Account #1 Amount:

Account #2:

Account #2 Amount:

Account #3:

Account #3 Amount:

Account#4:

Account#4 Amount:

*Meter Reading(s):

Payment Amount

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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