Payment agreement

WHILE YOU ARE WELCOME TO USE THIS SCREEN TO MAKE PAYMENTS, COLLECTION ACTIVITY WILL CONTINUE UNTIL YOU HAVE A SIGNED WRITTEN PAYMENT ARRANGEMENT PREPARED BY RUBIN & ROTHMAN, LLC. CALL 631 234-1500 AND ASK TO ENTER INTO A PAYMENT ARRANGEMENT.

I authorize Rubin & Rothman, LLC to debit the bank account indicated on this web form for the noted amount on the selected payment date. I understand that because this is an electronic transaction, these funds may be withdrawn from my account as early as the selected payment date or as late as 72 hours from the selected payment date. I agree not to dispute Rubin & Rothman, LLC debiting my checking account so long as the transaction corresponds to the terms indicated on this web form.

Making a payment via Rubin & Rothman, LLC’s Web Payment Portal will not establish a payment arrangement without a signed written payment agreement prepared by Rubin & Rothman, LLC.

Should you wish to revoke your authorization, you may do so by visiting this website or by contacting our office at the number listed below.

Last updated at: Nov 17th 2025