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  1. Notice:

    To help us reduce fraud please fill out the required form and submit. Once completed you will receive a confirmation page with the link to the payments page. Thank you for your help in reducing fraud in Trego County. 

  2. Located above address of services and/or above name. 

  3. Current Phone Number


  4. Transaction Signature *

                   

  5. Leave This Blank:

  6. This field is not part of the form submission.