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In addition to the payment you are making through this terminal for charges incurred at Lac qui Parle County Family Services, you will also incur a “Convenience Fee” payable to the third-party vendor GovTeller. The following is the Convenience Fee Schedule:

CONSUMER CONVENIENCE FEES:                
Master Card = $1.50 < $60 and 2.49% for $60.01 >
Visa credit/debit = $1.50 < $60 and 2.49% for $60.01 >
Visa Signature Debit = $3.95
American Express = 3.5% + $1.50
PIN Debit = $1.50 < $50 and 2.49% for $50.01 >    

PAYMENT DISCLAIMER
By submitting payment information through this Service, you agree to the terms and conditions of this Agreement. You further agree that this User Agreement forms a legally binding contract between you and Lac qui Parle County Family Services and that this Agreement constitutes “a writing signed by you” under any applicable law or regulation. Any rights not expressly granted herein are reserved by Lac qui Parle County Family Services. By clicking on the "Submit Payment" button, you are accepting these terms and the stated fees for using this service. Please remember to print this form for your records.