Form Center

2. Creating an account or logging in to Form Center is optional and is not required to submit this form.
4. This portal is for the payment of boiler invoices using a credit card, you may make a single payment if you have multiple invoices. This is a two step process - please fill out the following form. After you hit submit you will be taken to the pay by credit card button where you will complete the payment.
   
   For questions about your invoice or payment, please contact us during business hours at 785-296-3401 or email at boiler.inspection@ks.gov. You may fax the office at 785-296-0151.
   
   The receipts will be processed each business day, allow up to 2 weeks for the delivery of your certificates.
   
   This page is to pay for Boiler related payments only. At this time we are unable to accept payments for any other license or program except Boilers.
6. 
8. Please note we cannot accept American Express. We accept Visa, Mastercard and Discover.
10. Company Name*
12. Contact Name*
14. Phone Number*
    Please include area code and use hyphens to separate the numbers.
15. Email*
17. Name of Cardholder*
19. Amount You Intend to Pay on the Next Screen*
    Please enter the amount that you will pay on the next screen.
21. Invoice Number*
    If you have multiple invoice numbers - enter the invoice number hit the return key after each number.
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23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

* indicates a required field