Virtual Check
Payment
Merchant
MGM Associates of Rochester
Michael G Montag Insurance Agency Inc
1745 Penfield Road
Penfield, NY, 14526
cpavone@mgminsure.com
585-381-7008
Payer
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Address
Address2
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Phone
Check Info
Policy Number This Field is REQUIRED
Payee
Routing Number Verified Unverified
Account Number Verified Unverified
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Date
Amount
$
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I understand that submitting payment does not guarantee coverage until confirmed by the agency. Additionally, I understand that payment does not guarantee coverage in the event the policy has entered a cancellation status by the insurance company.