Payment By Check Submission

Griffin General Agency, Inc.
363 North Sam Houston Pkwy E #1000
Houston, TX 77060

(281) 820-0555
(800) 873-6500
(281) 820-0688
(800) 820-2350
info@gga-mga.com





Your Name (required)

Contact Phone Number

Your Email (required)

Policy Number (required)

Payment Amount
By checking accept, you acknowledge that a $5.00 Convenience Fee will be added to the payment amount.
ACCEPT

Check Sample

Name on Bank Account (required)

Bank Account Number (required)

Routing Number, 9 digit (required)

By checking accept, you acknowledge this constitutes a legal signature confirming your authorization for Griffin General Agency, Inc., hereinafter called COMPANY, to initiate debit entries to your account indicated and the depository named, hereinafter called DEPOSITORY, to debit the same amount plus the $5.00 Convenience Fee.

ACCEPT