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Payment Plan Application

Protect your privacy! Email is not a secure environment, so never send confidential information (i.e. Social Security numbers, tax account numbers) through Email. To protect your privacy, we will not send sensitive or confidential information to anyone by means of Email.

Fields marked with a red asterisk are required. Other fields are optional. The more information you can provide the quicker we can help you.

Enter your name.
Enter your debtor number or agency debt ID.
Enter the last 4 digits of your SSN.
Enter your address.
Enter your city.
Select your state.
Enter a valid ZIP code, such as 70802 or 70802-1234.
Enter your phone number in this format: (555) 555-5555.
Enter a valid email address, such as name@example.com.

Important

  • Submission of this application does not guarantee approval of a payment plan.
  • All requests are subject to review and approval by the Office of Debt Recovery.
  • If approved, the payment plan agreement will be issued electronically within approximately 3 business days.

Debt Information

Enter the total amount owed.
Enter your requested monthly payment amount.

Minimum Payment Requirement

The required minimum monthly payment is:

5% of the outstanding balance OR $25.00, whichever is greater. (ODR may require a higher payment amount based on the total balance owed.)

Acknowledgments and Terms

You must acknowledge the payment plan information before submitting.

Important Information About OMV Debt

If your debt includes Office of Motor Vehicles charges, additional requirements may apply.