Automatic Bank Draft Clause Samples

Automatic Bank Draft. You may be able to pay your ▇▇▇▇ by automatic bank draft (ACH). Please contact us for the most up-to-date payment options.

Automatic Bank Draft. I authorize Tatum Water Works to begin deductions from my account with the financial institution named below in the amount of my monthly water ▇▇▇▇. I understand that I may discontinue enrollment in ACH at any time by sending my request in writing to ▇▇▇▇▇ Water Works. I understand that as an ACH customer, I will continue to receive my monthly water ▇▇▇▇ for review only. I understand that both my financial institution and ▇▇▇▇▇ Water Works have the right to terminate this payment plan or my participation therein. I also understand that Tatum Water Works will not reimburse me for any fees charged by the bank for stop payments, non-sufficient funds, etc. Water ▇▇▇▇ Account Number: Name: Street Address: City/State/Zip Code: Home Phone Number: Mobile Number: Email Address: Financial Institution Name: Financial Institution’s Phone: Account Routing Number: Account Number: Name(s) Appearing on Account: Type of Account: Savings Checking Signature: Date: P. O. BOX 1105 ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇ ▇▇▇▇▇, TEXAS 75691 EMAIL: ▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇▇.▇▇▇▇▇.▇▇▇ DATE APPLICANT’S NAME (print) BILLING ADDRESS PHONE NUMBER EMAIL ADDRESS SOCIAL SECURITY NUMBER: DRIVER LICENSE # PHYSICAL LOCATION RESIDENTIAL/COMMERICAL PROPERTY OWNER/RENTER SERVICES DESIRED WATER SEWER WATER TAP SEWER TAP EMPLOYER=S NAME & ADDRESS: EMPLOYER’S PHONE NUMBER CUSTOMER’S SIGNATURE: ***** TAMPERING WITH A CITY WATER METER IS A CRIME AND PUNISHABLE BY LAW. VIOLATORS WILL BE PROSECUTED ***** METER NUMBER: CURRENT METER READING PREVIOUS READING _ NEW ACCOUNT NUMBER PREVIOUS ACCOUNT NUMBER