Automatic Payment Plan Agreement Sample Contracts
AUTOMATIC PAYMENT PLAN AGREEMENTAutomatic Payment Plan Agreement • July 2nd, 2013
Please print name, address and account number exactly as they appear on your bill: Name: Service Address: Account #: Telephone #: Best time to call: E-mail: Billing Statement Delivery: ☐ Email☐ Postal Mail Mailing address, if different than above: Street or P.O. Box address: City: State: BANK ACCOUNT INFORMATION Bank Name: Bank Address: Bank Telephone #: Routing Number: Checking: Savings: Account Number:
ContractAutomatic Payment Plan Agreement • June 29th, 2020
ALVIN, TX 77511 AUTHORIZATION AGREEMENT FOR PREARRANGED PAYMENTSAutomatic Payment Plan Agreement • February 21st, 2006
AUTHORIZATION AGREEMENTAutomatic Payment Plan Agreement • October 28th, 2019
Stratford Water & Electric Automatic Payment Plan AgreementAutomatic Payment Plan Agreement • March 9th, 2016
I realize that utility bills may vary sub- stantially, depending on usage and rates. Normal procedures will provide plenty of time to review my bill prior to deduction from my account.
AUTOMATIC PAYMENT PLAN AGREEMENT FORMAutomatic Payment Plan Agreement • February 13th, 2019
Based on the above, I hereby authorize Hartford Utilities and the financial institution named above to initiate entries to my checking/savings account for payment of my monthly utility bills. This authorization will remain in effect until I terminate it, allowing reasonable time for Hartford Utilities and my bank to act. I have the right to stop payment on an individual entry or to have entries corrected by timely notification to my financial institution. Hartford Utilities also has the right to cancel this agreement for insufficient payments to my account.
Washington Electric Cooperative, Inc.Automatic Payment Plan Agreement • March 2nd, 2015
ContractAutomatic Payment Plan Agreement • August 17th, 2017
CITY OF WILLIAMSBURGAutomatic Payment Plan Agreement • August 5th, 2004
The billing statement will advise you of the amount which will be deducted and will read- “DO NOT PAY.” Fifteen days after your billing statement date, the amount due will be automatically deducted from your bank account. Please contact the Water/Utility Department with any questions on your billing statement (757-220-6188). Allow a complete billing cycle, 30 days/monthly and 90 days/quarterly, for the plan to begin.
AUTOMATIC PAYMENT PLAN APPLICATION FORM *At this time, Auto-Pay is only offered for Utility bills* Return this form with a voided check to: The Town of Altavista, 510 7th Street or P. O. Box 420 Altavista, VA 24517 Customer Name: Utility Account No.:...Automatic Payment Plan Agreement • November 28th, 2018
AUTOMATIC PAYMENT PLAN AGREEMENTAutomatic Payment Plan Agreement • July 27th, 2017
Based on the above, I hereby authorize the City of Muskego Utilities to direct debit my account for my quarterly utility bill, which may include any/or all of the following: water, sewer, or refuse & recycling. The City of Muskego Utilities must receive authorization fifteen (15) days prior to the end of the quarter.
TIMPANOGOS HIGH SCHOOL AUTOMATIC PAYMENT PLAN AGREEMENTAutomatic Payment Plan Agreement • July 18th, 2016
Timpanogos High School is offering you the opportunity to have your student’s required school fees transferred automatically from your checking account and deposited directly into the school’s account free of charge. Only the
LANCASTER WATER & SEWER DEPARTMENTAutomatic Payment Plan Agreement • November 20th, 2014
QuickCheck Automatic Payment Plan AgreementAutomatic Payment Plan Agreement • March 13th, 2006
● Depending on when you enroll in QuickCheck, deductions will begin on the first or second bill. Watch for the words “QuickCheck Amount” to appear on your bill.
Option 1 – Full PaymentAutomatic Payment Plan Agreement • May 6th, 2022
I/We authorize GrandBridge Energy (formerly Brantford Power) to automatically debit my bank account for the full amount specified on my bill, on the due date indicated on my bill. This authorization is valid for all regular bills, reconciliation bills, and final bills.
Automatic Payment Plan Application and AgreementAutomatic Payment Plan Agreement • July 2nd, 2015
You can authorize the City of North Las Vegas and your bank to handle the utility payment transaction for you. You will continue to receive your monthly bill indicating exactly how much it is and when the amount will be deducted from your bank account. Complete this form, attach a voided check, and return the form with your next utility payment. Within two (2) billings, a notice of enrollment in the plan will appear on your bill. Continue to make payments until such notice appears.
Automatic Payment Plan AgreementAutomatic Payment Plan Agreement • June 24th, 2024
When you choose to enroll in Atmos Energy’s Automatic Payment Plan, you agree to meet the requirements of and to be bound by the terms and conditions of this Automatic Payment Plan Agreement (“Agreement”). From time to time, and at any time, you understand that the terms of this Agreement may be changed and that you will be bound by the changes until you terminate your enrollment in this Agreement.
AUTHORIZATION AGREEMENT FOR PREARRANGED PAYMENTSAutomatic Payment Plan Agreement • June 23rd, 2022
AUTOMATIC PAYMENT PLAN AGREEMENT FORMAutomatic Payment Plan Agreement • June 28th, 2022
Based on the above, I hereby authorize Hartford Utilities and the financial institution named above to initiate entries to my checking/savings account for payment of my monthly utility bills. This authorization will remain in effect until I terminate it, allowing reasonable time for Hartford Utilities and my bank to act. I have the right to stop payment on an individual entry or to have entries corrected by timely notification to my financial institution. Hartford Utilities also has the right to cancel this agreement for insufficient payments to my account.
Automatic Payment Plan AgreementAutomatic Payment Plan Agreement • May 26th, 2023
When you choose to enroll in Atmos Energy’s Automatic Payment Plan, you are agreeing to meet the requirements of and to be bound by the terms and conditions of this Automatic Payment Plan Agreement (“Agreement”). From time to time, and at any time, you understand that the terms of this Agreement may be changed and that will be bound by the changes until terminate your enrollment of this Agreement.
Authorization Agreement for Pre-Arranged Payments (Debits) Company Name: DPUA/DP&L I.D. Number 73-1234579Automatic Payment Plan Agreement • May 14th, 2013
Authorization Agreement for Pre-Arranged Payments (Debits) Company Name: DPUA/DP&L I.D. Number 73-1234579Automatic Payment Plan Agreement • April 27th, 2022
Automatic Payment Plan Application and AgreementAutomatic Payment Plan Agreement • September 9th, 2020
To join the Automatic Payment Plan, complete this form, attach a voided check and return to Snow Property Services. You will receive email notice once your auto pay has been set up. Please continue to mail your payment to our office until you receive notice. If you have questions, please contact our office at 480-635-1133.
A UTOMATIC PAYMENT PLAN AGREEMENT FORMAutomatic Payment Plan Agreement • December 3rd, 2019
Based on the above, I hereby authorize Hartford Utilities and the financial institution named above to initiate entries to my checking/savings account for payment of my monthly utility bills. This authorization will remain in effect until I terminate it, allowing reasonable time for Hartford Utilities and my bank to act. I have the right to stop payment on an individual entry or to have entries corrected by timely notification to my financial institution. Hartford Utilities also has the right to cancel this agreement for insufficient payments to my account.
City of FulshearAutomatic Payment Plan Agreement • March 2nd, 2015
• We will draft the net amount due on your account from your banking institution account and mail you a courtesy copy of your utility bill for your records.
Stratford Water & Electric Automatic Payment Plan AgreementAutomatic Payment Plan Agreement • March 9th, 2016
• I realize that utility bills may vary sub- stantially, depending on usage and rates. Normal procedures will provide plenty of time to review my bill prior to deduction from my account.
AUTOMATIC PAYMENT PLANAutomatic Payment Plan Agreement • March 21st, 2023
You can save time and money by automatically paying your utility bill (water, electric and sewer) through your checking or savings account. There is no charge for this service. You will continue to receive your monthly utility bill as usual. Automatic payments are processed each month on the due date listed on your utility bill (with adjustments for bank holidays).
AUTOMATIC PAYMENT PLAN AGREEMENTAutomatic Payment Plan Agreement • September 11th, 2018
Our Automatic Payment Plan is a means by which your utility payment will be automatically deducted from your checking or savings account each month.