Please provide us with the following information about your organization. All fields are required unless otherwise noted.
Please provide us with your contact information. All fields are required.
Please provide us with your desired payment schedule and method. All fields are required.
Please identify the type of service you provide in any of the GCRECD's eight county region (Brazoira, Chambers, Colorado, Liberty, Matagorda, Walker, Waller, Wharton):
The 9-1-1 Service Fee online payment form will require you to log in to submit a payment on behalf of your organization.
Please create a password to use. This password will be used with your Taxpayer Identification Number (TIN) to log into the 9-1-1 Service Fee online payment form.
Passwords must be at least 8 characters long, and contain at least 1 letter and 1 number.
Kimberly Ward firstname.lastname@example.org 713-993-2459
Service Fee Remittance Instructions
Service Fee Remittance Frequently Asked Questions