The MoneyGram® ExpressPayment® form is a tool that allows customers to send cash payments for bills or load prepaid cards quickly and efficiently. This form requires specific information from the sender, including their name, contact details, and payment details. Ready to make a payment? Fill out the form by clicking the button below.
The MoneyGram Express Payment form is a vital tool for individuals looking to send money quickly and efficiently, whether for paying bills or loading prepaid cards. This form is designed to streamline the payment process, ensuring that users can provide essential information with ease. It includes sections for the sender's full name, contact information, and address, which are crucial for identifying the sender and facilitating the transaction. Additionally, users can specify the company name and account number for the bill they wish to pay, as well as the amount they intend to send. For those loading prepaid cards, the form allows for the entry of the prepaid card number and the desired loading amount. A unique feature of the form is the option to include a message to the biller or beneficiary, enhancing communication. Furthermore, the form outlines important terms and conditions, including details on refunds, maximum transaction limits, and the responsibilities of both the sender and the receiver. By understanding these key aspects, users can navigate the MoneyGram Express Payment service with confidence, ensuring that their transactions are processed smoothly and securely.
MoneyGram® ExpressPayment® Service
Bills Paid Today, Cards Loaded Now
Facturas pagadas hoy, tarjetas cargadas ahora
To be completed by the customer
Datos que debe completar el cliente
CUSTOMER COPY
Sender’s Full Name
Sender’s Main Telephone Number
Nombre completo del remitente (First Name/Middle Name/Last Name Primer Nombre/Segundo Nombre/A pellido)
Número telefónico principal del remitente
Sender’s Address
Domicilio del remitente
City
State
Zip Code
Ciudad
Estado
C.P.
Sender’s Signature
Date
Firma del remitente
Fecha
7598GMG5001S EXP (REV 11/10)
Pay a bill (Same-day notification) Pagar una factura (Notificación al mismo día)
Company Name
Nombre de la compañía
City & State (optional)
Ciudad y estado (opcional)
Receive Code (optional)
Código de Recibo (opcional)
Account Number of the Bill to Pay
Número de cuenta de la factura a pagar
Amount to Pay
$
Monto a pagar
Message to Biller or Beneficiary Name
(Maximum of 40 characters. Not all companies have the ability to transmit this message.)
Mensaje para el emisor de factura o el nombre del beneficiario
(40 caracteres máximo. No todas las compañías tienen la capacidad de transmitir este mensaje.)
Load a prepaid card Cargar una tarjeta prepagada
Prepaid Card Number to Load
Numero de la tarjeta prepagada a cargar
Amount to Load
Monto a cargar
Popular Prepaid Card Receive Codes
Código de control de tarjetas prepagadas comunes
AccountNow
. . . . . . . . . . . . . . . . . . . . .
4070
NetSpend
7000
BabyPhat Prepaid Visa RushCard
2495
RushCard
.2495
H&R Block Emerald Prepaid MasterCard . . .
4941
Univision Prepaid Mastercard
.7308
Money Network
.7174
Visa ReadyLink
.7034
You can pay thousands of bills and load hundreds of cards with MoneyGram. Puede pagar miles de facturas y cargar cientos de tarjetas con MoneyGram.
TERMS AND CONDITIONS: A MoneyGram® ExpressPayment® Service (the “Service”) customer that is located in the United States (a “Sender”) may send a cash payment (a “Payment” or a “Transfer”) to an entity with whom MoneyGram has contracted (i.e., the receiver of Your payment and hereafter the “Receiver”) as a payment for credit on a bill in the United States. A Receiver may also include, and Transfers may also be made to, a third party prepaid debit card issued by a U.S. company, a MoneyGram® branded prepaid debit card, and such other entities determined by MoneyGram from time to time in its sole discretion. The Service is provided by MoneyGram Payment Systems, Inc., a money transmitter with its principal office at 1550 Utica Avenue South, Minneapolis, MN 55416 (“MoneyGram”) through a network of agents (“Agents”). Call 1-800-926-9400 for information and for the address and phone number of Agent locations near You. “You” or “Your” may be used to refer to the Sender and/or the Receiver depending on the context in which it used. The ExpressPayment trademark, and all intellectual property pertaining to the Service (including but not limited to copyrights, patents, and service marks) are owned by MoneyGram International, Inc., and all right, title, and interest shall remain the property of MoneyGram International, Inc. The ExpressPayment® trademark may not be used without the express written consent of MoneyGram.
Send Information. The Sender/Receiver represents, warrants and certifies to MoneyGram that its and their use of the Service shall not in any way, directly or indirectly, violate any law, statute, ordinance, contract, or regulation, including but not limited to, any law, statute, ordinance, contract, or regulation relating to money laundering, illegal gambling activities, support for terrorist activities, fraud, or theft. Maximum permissible amounts for a single ExpressPayment transaction and daily Transfer totals will be applied. When required by applicable law, Your MoneyGram ExpressPayment Transfers will be reported to federal, state, local, or foreign authorities. In addition, MoneyGram will cooperate with law enforcement in the prosecution of illegal activities to the fullest extent permitted by applicable law. Neither the Sender nor Receiver will have a “deposit” with MoneyGram at any time during the Transfer. You agree and warrant that all information You provide is not false, inaccurate, or misleading. The next day and 2-3 day bill payment services are not intended for the payment of disconnect shutoff, or similar notices.
Receive Information. A Transfer is received and MoneyGram has no further liability to You, except as set forth below, when notification of your Transfer is made available to the Receiver as identified in the Receive Code supplied on the MoneyGram® ExpressPayment® service form. Your Transfer may ultimately not be accepted by the Receiver and, in such event, the amount of your Transfer will be available to you as a refund. MoneyGram makes no representation as to when the Transfer (including any amounts transferred to a prepaid card) will be available or accepted by the Receiver or when amounts transferred or loaded on to a prepaid card will be available.
Refund Information. 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. The Consumer Fee is usually not refundable. Some refunds may be delayed until MoneyGram receives official notification that a Transfer has not been accepted. 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® ExpressPayment® 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, Inc., ATTN: Refund Coordinator, 3940 South Teller Street, Lakewood, CO 80235 USA.
RIGHT TO REFUND. You,thecustomer,areentitledtoarefundofthemoneytobetransmittedastheresultofthis agreementifMoneyGramPaymentSystems,Inc.,(MoneyGram)doesnotforwardthemoneyreceivedfromyouwithin 10 days of the date of its receipt, or does not give instructions committing an equivalent amount of money to the persondesignatedbyyouwithin10daysofthedateofreceiptoffundsfromyouunlessotherwiseinstructedbyyou. If your instructions as to when the moneys shall be forwarded or transmitted are not complied with and the money hasnotyetbeenforwardedortransmitted,youhavearighttoarefundofyourmoney.Ifyouwantarefund,youmust mail or deliver your written request to MoneyGram Payment Systems, Inc., ATTN: Refund Coordinator, 3940 S. Teller Street,Lakewood,CO80235.Ifyoudonotreceiveyourrefund,youmaybeentitledtoyourmoneybackplusapenalty ofupto$1,000andattorney’sfeespursuanttoSection2102oftheCaliforniaFinancialCode.
Liability. In the event of any delay, nondelivery, nonpayment, or underpayment of the transfer, unless prohibited by applicable law, your exclusive and maximum remedy against moneygram is refund of the transfer amount (the amount to be paid or loaded by you) plus the consumer fee set forth on this
form. No other remedy is available to you, including, but not limited to no remedy for incidential, indirect, special, or consequential damages. These limitations apply whether your claim arises due to moneygram or itʼs agentsʼ negligence relating to human or mechanical error or otherwise, or to moneygram or its agentsʼ other fault, error, ommission, or nonperformance. Moneygram will not be liable for any variances or service delays due to local regulations or causes beyond the control of moneygram.
Arbitration. Unless otherwise specified by applicable law, any controversy or claim arising out of or relating to the transfer, this contract or breach of this contract, shall be settled by arbitration administered by the american arbitration association under its commerical arbitration rules and judgement on the award rendered by the arbitrator(s) may be entered in any court having jurisdiction thereof. Any such arbitration shall be initiated in the office of the
aaaclosest to the location where you initiated the transfer and this exclusive arbitration remedy shall not be maintained unless initiated within one year after the controversy or claim arose.
Privacy Notice. MoneyGram and its Agent use and save your and Senderʼs personal information and Transfer details, to provide Transfer services, manage our business, and for marketing. All personal information collected may be disclosed to our affiliates, Agents, and service providers, or as otherwise permitted by law. If fraud is suspected, your information will be shared with relevant law enforcement in the US and other countries, which may further share the information. Security measures are used to restrict access to personal information. To opt-out of receiving information about products and services, email marketingpreferences@moneygram.com or call 1-800-926-9400; allow at least 4 weeks for processing. Rewards® members may visit www.moneygram.com to opt-out. The website contains our most current privacy policy. Notice of changes will be made as required by law.
TÉRMINOS Y CONDICIONES: Un cliente del servicio MoneyGram® ExpressPayment® (el “Servicio”) que se encuentra en los Estados Unidos (el “Remitente”) puede enviar un pago en efectivo (un “Pago” o una “Transferencia”) a una entidad con quien MoneyGram tenga un acuerdo (es decir, el receptor de su pago, en adelante el “Destinatario”) a modo de pago de una factura por un crédito en los Estados Unidos. Un tercero con tarjeta de débito prepaga emitida por una compañía de los EE. UU., una tarjeta de débito prepaga MoneyGram® y cualquier otra entidad que MoneyGram determine oportunamente a su exclusiva discreción también pueden ser Destinatarios y pueden recibir Transferencias. El servicio es proporcionado por MoneyGram Payment Systems, Inc., una compañía de transferencias de dinero con oficina principal en 1550 Utica Avenue South, Minneapolis, MN 55416 (“MoneyGram”) a través de una red de agentes (“Agentes”). Comuníquese al 1-800-955-7777 para solicitar información, las direcciones y los números de teléfono de los Agentes más cercanos a su domicilio. “Usted” o “Su” puede utilizarse para referirse al Remitente o al Destinatario, dependiendo del contexto en el cual es empleado. La marca registrada de ExpressPayment y toda la propiedad intelectual perteneciente al Servicio (incluidos, entre otros, derechos de autor, patentes y marcas de servicios) son propiedad de MoneyGram International, Inc.; y todo derecho, título e interés serán propiedad de MoneyGram International, Inc. La marca registrada de ExpressPayment® no puede utilizarse sin el consentimiento expreso por escrito de MoneyGram.
Información de Envío. El Remitente/Destinatario declara, garantiza y certifica a MoneyGram que su uso del Servicio no infringirá ninguna ley, estatuto, ordenanza, contrato o regulación en forma directa o indirecta, incluidos, en forma enumerativa, cualquier ley, estatuto, ordenanza, contrato o regulación relativa al lavado de dinero, actividades de apuestas ilegales, apoyo a actividades terroristas, fraude o robo. Se aplicarán los montos máximos permitidos para una sola transacción de ExpressPayment y los totales de las transferencias diarias. Cuando fuera requerido por la ley correspondiente, se notificará acerca de sus Transferencias realizadas por MoneyGram ExpressPayment a las autoridades federales, estatales, locales o extranjeras. Asimismo, MoneyGram colaborará con las autoridades judiciales en procesar actividades ilegales en la medida en que lo permita la ley correspondiente. Ni el Remitente ni el Destinatario tendrán un “depósito” con MoneyGram en ningún momento durante la Transferencia. Usted acepta y garantiza que toda la información que Usted proporciona no es falsa, imprecisa ni engañosa. Los servicios de pago de cuentas al día siguiente y en 2 o 3 días no deben usarse para el pago de avisos de corte, desconexión o avisos similares.
Información de Cobro. Una vez recibida la Transferencia, MoneyGram deja de tener responsabilidad ante Usted, excepto según lo establecido a continuación, cuando se notifica el pago de la Transferencia al Destinatario como lo establece el Código de control proporcionado en el formulario de servicio de MoneyGram® ExpressPayment®. Su Transferencia puede ser rechazada en última instancia por el Destinatario; en tal caso, se le reembolsará el monto de su Transferencia. MoneyGram no estipula de ninguna manera cuándo estará disponible la Transferencia (incluidos los montos transferidos a una tarjeta prepaga) o cuándo el Destinatario aceptará la transferencia o cuándo los montos transferidos o cargados en una tarjeta prepaga estarán disponibles.
Información Acerca de Reembolsos. Si usted proporciona de manera incorrecta el Código de Recibo, el nombre del Destinatario o el Número de cuenta, es posible que la Transferencia se envíe al sitio equivocado y, en tal caso, no tendrá derecho a un reembolso, aun cuando la persona a quien procuraba enviar dicha Transferencia no la hubiera recibido. Generalmente no se reembolsan las comisiones cobradas a los consumidores. A veces sucede que algunos reembolsos son demorados hasta que MoneyGram recibe la notificación oficial de que no se ha aceptado la Transferencia. Las solicitudes de reembolso pueden realizarse en la Agencia donde se originó la Transferencia o presentando una nota a MoneyGram. Todas las solicitudes de reembolso deben presentarse con una copia original del formulario de servicio de MoneyGram® ExpressPayment®. Todas las solicitudes de reembolso están sujetas a la revisión y discreción de MoneyGram y, por lo general, se procesan dentro de los 30 días de recibir la solicitud válida por escrito, a no ser que por ley se requiera su procesamiento en un período más corto. Envíe por correo la solicitud de reembolso y/o cualquier otra correspondencia a MoneyGram Payment System, Inc., ATTN: Refund Coordinator, 3940 South Teller Street, Lakewood, CO 80235 USA.
DERECHO A REEMBOLSO. Usted, el cliente, tiene derecho a recibir el reembolso del dinero que será transferido como resultado de este acuerdo, si MoneyGram Payment Systems, Inc. (MoneyGram) no envía el dinero que usted entregue dentro de los siguientes 10 días posteriores a la fecha de recibo, o si no da instrucciones de consignar una cantidadequivalentededineroalapersonaqueustedhayadesignado,dentrodelossiguientes10díasposteriores a la fecha de recibo de los fondos que usted entregó, a menos que usted haya dado instrucciones diferentes. Si no se cumplen las instrucciones que usted haya dado, relativas al día en que el dinero debe ser enviado o transferido y el dinero aún no ha sido enviadoo transferido, usted tiene el derecho a recibir un reembolso de su dinero. Si desea recibir un reembolso, deberá entregar o enviar por correo su solicitud por escrito a MoneyGram Payment Systems, Inc., ATTN.: Refund Coordinator, 3940 S. Teller Street, Lakewood, CO 80235. Si no recibe el reembolso, puede tener derechoarecibirsudineroademásdeunapenalidadhastade$1,000yloscostosdeunabogado,segúnloestablece la Sección 2102 del Código Financiero de California (California Financial Code).
Responsabilidad civil. En caso de cualquier retraso, falta de entrega, falta de pago o pago menor de la transferencia, a menos que fuera prohibido por la ley correspondiente, su único y máximo recurso en contra de moneygram es el reembolso de la suma de la transferencia (la suma que usted paga o carga) más la comisión del consumidor estipulada en este formulario. No existe ningún otro recurso disponible, entre otros, recursos por daños incidentales, indirectos, especiales o sobrevinientes. Estas limitaciones se aplican independientemente de que su reclamo surja debido a la negligencia de moneygram o sus agentes, debido a errores humanos o mecánicos o de otro tipo, o debido a la falla, error, omisión o incumplimiento de moneygram o de sus agentes. Moneygram no será responsable por ninguna variación o retraso de servicio debido a reglamentaciones locales o causas ajenas al control de moneygram.
Arbitraje. A menos que la ley vigente especifique lo contrario, cualquier controversia o reclamo que surja de la transferencia o en relación con ella, o de este contrato o su incumplimiento, será resuelto por el arbitraje conducido por la asociación estadounidense de arbitraje en cumplimiento de las reglas de arbitraje comercial y la sentencia sobre el laudo pronunciado por el árbitro o los árbitros puede ser dictada en cualquier tribunal competente. Todo arbitraje será iniciado en la oficina de aaa más cercana al sitio donde se haya realizado la transferencia y este recurso exclusivo de arbitraje no procederá a menos que se inicie dentro del año siguiente a partir de la fecha en que surge la controversia o el reclamo.
Notificación de privacidad. MoneyGram y sus Agentes utilizan y guardan la información personal y los detalles de transferencias de usted y del remitente con el objetivo de brindar servicios de transferencia, administrar nuestra empresa y realizar actividades de comercialización. Toda la información personal recopilada se divulgará a nuestras filiales, Agentes y proveedores de servicio, o según lo permita o requiera la ley. Si se sospecha que pudo haber un fraude, su información se compartirá con las autoridades judiciales pertinentes de los EE. UU. y de otros países, quienes a su vez también podrán compartir la información. Las medidas de seguridad se utilizan para restringir el acceso a la información personal. Para optar por no recibir información sobre productos y servicios, puede enviar un correo electrónico a marketingpreferences@moneygram.com o comunicarse al 1-800-955-7777; el procesamiento tardará 4 semanas, como mínimo. Los miembros Rewards® pueden visitar www.moneygram.com para excluirse. El sitio web también contendrá nuestra política de privacidad más actual. Se emitirán notificaciones de cambio según lo estipule la ley.
7598G
Filling out the MoneyGram Express Payment form is a straightforward process that allows you to send payments quickly and efficiently. To ensure that your transaction is processed without any issues, it is important to provide accurate information. Below are the steps you should follow to complete the form correctly.
After completing these steps, review the form for accuracy before submitting it to MoneyGram. This will help ensure that your payment is processed smoothly and reaches the intended recipient without delay.
The MoneyGram Express Payment form is utilized for sending cash payments to various entities, such as utility companies or prepaid debit card providers. It allows customers to pay bills and load funds onto prepaid cards quickly and efficiently. This service is particularly useful for individuals who need to make same-day payments or transfers.
When filling out the MoneyGram Express Payment form, you will need to provide several key pieces of information:
Make sure all information is accurate to avoid any issues with your transfer.
Providing incorrect information, such as a wrong receive code or account number, can lead to misdirected transfers. In such cases, you may not be entitled to a refund, even if the intended recipient did not receive the funds. It's crucial to double-check all details before submitting the form to ensure a smooth transaction.
If you need to request a refund, you must do so by visiting the agent location where the transfer originated or by sending a written request to MoneyGram. Include a copy of the original MoneyGram Express Payment form with your request. Refund requests are generally processed within 30 days, but this can vary based on the circumstances. Keep in mind that some fees may not be refundable.
Filling out the MoneyGram Express Payment form is a straightforward process, yet many individuals make common mistakes that can lead to complications. One prevalent error is failing to provide complete and accurate personal information. The form requires the sender's full name, address, and telephone number. Omitting any of these details can result in delays or even the misdirection of funds. It is crucial to double-check that all entries are clear and correct, as any discrepancies may hinder the transaction.
Another mistake often encountered is the incorrect entry of the account number or the receive code. These numbers are vital for ensuring that the payment reaches the intended recipient. If the account number is entered incorrectly, the funds may be sent to the wrong account, and the sender may not be entitled to a refund. It is imperative to verify these numbers against the bill or card information before submission.
Additionally, many individuals neglect to consider the optional fields in the form, such as the message to the biller or beneficiary. While these fields may seem insignificant, they can provide essential context for the payment. If a message is necessary for the recipient to understand the purpose of the payment, failing to include it can lead to confusion and delays. Always assess whether adding a message could enhance the clarity of the transaction.
Lastly, some users overlook the importance of signing and dating the form. A signature is not just a formality; it serves as a confirmation of the sender’s agreement to the transaction terms. Without a signature, the transaction may be deemed invalid, and the funds could be held up. Ensure that the form is signed and dated correctly to facilitate a smooth transfer process.
When using the MoneyGram Express Payment form, there are several other forms and documents that may be required or helpful. Each of these documents serves a specific purpose in facilitating transactions and ensuring compliance with regulations. Below is a list of these forms and a brief description of each.
Having these documents ready can streamline the transaction process and help ensure compliance with MoneyGram's policies. Always check with MoneyGram for specific requirements related to your transaction.
When filling out the MoneyGram Express Payment form, it is essential to approach the task with care. Here is a list of things you should and shouldn't do to ensure a smooth transaction.
Here are some key takeaways about filling out and using the MoneyGram Express Payment form: