MAKE A PAYMENT - CHECKING/SAVINGS ACCOUNT W/D Exact Name on Bank Acct:   Routing Number:   Account Number :   Amount:                                 $  Enter the amount you wish to pay. PointGain Account Name: (if different than cardholder)   E-mail Address:   E-mail Address:   Billing Address 1:   Billing Address 2:   Billing City, State, Zip Code:  ,