Mercury Insurance

Boost Express Enrollment Form and Card Acceptance Agreement

Strengthen your customer relationships and accelerate cash flow. Enroll now in Mercury Insurance Group’s new AP Direct payment program.

    Accounts Receivable Contact Information for Remittance Notification

    Agreement to Accept Card Payments

    Supplier's signatory is authorized to enter into this Agreement on behalf of Supplier.

    I hereby agree to accept card payments from Mercury Insurance Group.

    To use CAPTCHA, you need Really Simple CAPTCHA plugin installed.

    *Required fields

    Questions? Contact Boost at (888)-222-7122 or email us at