Quick Pay Request Form
Please use this form to request Quick Pay prior to load delivery. Once you submit the form, please send all required paperwork (invoice, signed BOL, signed rate confirmation as well as a voided check if expecting funds via wire) to quickpay@eta-agency.us & note the load number in the subject field.
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Email *
What is your name/title? *
What trucking company do you represent? *
Do you understand Quick Pay must be requested BEFORE the load is delivered? *
What is the load number you are requesting Quick Pay for? *
What is the invoice number you are requesting Quick Pay for? *
Do you understand there is a 5% fee for ALL Quick Pays & the minimum fee per Quick Pay is $50.00? *
Do you understand Quick Pay is NOT an option for carriers under contract with a factoring company? *
Do you understand Quick Pays under $9950.00 (after fees) will be wired within 48 business hours? *
Do you understand Quick Pays $9951.00 & up (after fees) will be paid by check & mailed via USPS Priority Mail within 24 business hours? *
Do you understand the name on the checking account must be the same as the company on the rate confirmation & must match the MC Trucking Authority on file? *
What is the name of your bank? (Type N/A if Quick Pay is over $9951) *
What is your bank's routing number for wire transfers? (Type N/A if Quick Pay is over $9951) *
What is your bank account number? (Type N/A if Quick Pay is over $9951) *
Do you understand there will be additional fees if the routing number &/or account number provided on this form are incorrect? *
Please let us know the best number to reach you should we have any questions during the Quick Pay process. *
As a reminder, you must send all required paperwork to quickpay@eta-agency.us for your Quick Pay to be processed. Do you understand the promised time begins once ALL paperwork is received? *
If there is anything else you would like us to know?
A copy of your responses will be emailed to the address you provided.
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