Escambia County Credit Card Payment by Mail Form (PDF)

The Credit Card Payment by Mail Form, printed on the PDF as Customer Payment Information, is the Escambia County Tax Collector form on which a customer writes the credit card or checking/savings account details to be used for a payment sent by mail.

The form has two blocks:

• Credit Card: Cardholder Name, Card Number, Expiration Date, Security Code, Daytime Phone Number, Address and City, State, Zip.
• Checking/Savings Account: Account Holder Name, Email Address, Daytime Phone Number, Address, City, State, Zip, Bank Name, Account Type (checking/savings), Routing Number and Account Number.

A RESET button is printed at the top of the PDF. The footer line gives the revision as Customer Payment Information – Rev - 04/13/2020 and places the file in the agency's Motor Vehicles forms folder.

The form is only a payment information sheet. It does not name the tax, fee or transaction being paid, and it prints no amount, signature line or mailing address, so it works as a companion to whatever payment you are making to the Escambia County Tax Collector.

Customers who are paying the Escambia County Tax Collector by mail, and who want to give a credit card or a checking or savings account as the payment method, use this form. The form's name, Credit Card Payment by Mail Form, describes that situation.

• Choose the Credit Card block if you are paying by card. The block asks for the cardholder's name, card number, expiration date and security code, plus a daytime phone number and the cardholder's address.
• Choose the Checking/Savings Account block if you are paying from a bank account. That block asks for the account holder's name, email address, daytime phone number and address, together with the bank name, account type, routing number and account number.

The form prints no eligibility rules and no exclusions. It also prints no signature line and says nothing about whether another person may complete it for you, so questions about who may provide payment details on your behalf go to the Escambia County Tax Collector.

The form has no due date of its own. It carries your payment details for a payment sent by mail, so it goes out at the time you send that payment, and the deadline that matters is the one that applies to the payment itself. The PDF prints no filing window, renewal cycle or processing time. For the due date of what you are paying, contact the Escambia County Tax Collector through escambiataxcollector.com.

The form itself names no channel or address. Its title, Credit Card Payment by Mail Form, indicates that it accompanies a payment sent by mail, but the PDF prints no mailing address, P.O. box, portal or phone number.

• Mail: send the completed form with your payment to the address the Escambia County Tax Collector gives for that payment. Confirm the address with the office before you mail the form.
• Agency website: the Escambia County Tax Collector publishes the PDF at https://escambiataxcollector.com/wp-content/uploads/2025/07/Customer-Payment-Information-Form.pdf and its other resources at escambiataxcollector.com.

Because the form holds card or bank account numbers, check that every entry is correct and complete before you print it. The form states no fee, no amount to enter and no status-check method. FillingPDF lets you fill out and download the PDF; submission follows the agency's channels above.