MoneyGram Bill Payment form at a glance
What it is: The MoneyGram Bill Payment form is to be completed by the customer to send a cash payment as a payment for credit on an invoice.
Who signs: The sender signs.
A Bill Payment Service customer that is located in Canada may send a cash payment to an entity located in Canada with whom MoneyGram has contracted or otherwise designated, as a payment for credit on an invoice of a Receiver.
A filled-in MoneyGram Bill Payment form example: paying two bills
How to fill out MoneyGram Bill Payment form, box by box
The bill to pay
Enter the Account number of the bill to pay.
Enter the Amount to Pay.
Enter the Receive Code (Optional) or the Company Name.
Message to Company has a maximum of 40 characters. Not all companies have the ability to transmit this message.
More rules for MoneyGram Bill Payment form
Enter the Sender's Full Name: First Name, Middle Name, Last Name.
Enter the Sender's Main Telephone Number.
Enter the Sender's Address.
Enter the Postal Code, the Town/City and the Province.
Check this box if you do not want to receive any marketing communications from MoneyGram.
This transaction is subject to the terms and conditions. Those terms and conditions limit the sender's legal rights and should be reviewed prior to signing.
Call 1-800-926-9400 for information and for the address and phone number of Agent locations near you.
Maximum permissible amounts for a single Bill Payment transaction and daily Transfer totals will be applied.
If you supply the wrong Receive Code, Receiver Name, or Account Number, the Transfer may be misdirected and, in such event, you shall not be entitled to a refund even though the intended party did not receive your Transfer.
Refund requests may be made either by visiting the Agent location where the Transfer originated or writing to Moneygram. All refund requests must be accompanied by a copy of the original Moneygram Bill Payment service form.
All refund requests will be subject to MoneyGram review and discretion and will normally be processed within 30 days of receipt of a valid written request unless a shorter period is required by law.
Mail refund request and/or any correspondence to MoneyGram Payment Systems Canada, Inc., ATTN: Refund Coordinator, 3940 South Teller Street, Lakewood, CO 80235 USA.
Common questions about MoneyGram Bill Payment form
Who signs it?
Sign on the Sender's Signature line and enter the Date.
Are there fees?
The Consumer Fee is usually not refundable.
What am I certifying when I sign?
You warrant that all information you supply to MoneyGram is and shall remain accurate and complete.
Sources
[1] MoneyGram Bill Payment form, (Rev 07/11) (the served file; no issuer file found) (the Official source link on this page).