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City of Wayne
Automatic Payment Plan
You can have your City of Wayne Utility payment made
automatically from your checking or savings account. And, you won't have to
change your present banking relationship to take advantage of this service.
The Automatic
Payment Plan will help you in several ways:
·
it saves time - fewer checks to write
·
makes your payment in a convenient and timely manner - even if you're on
vacation or out of town
·
no lost or misplaced statements, your payment is always on time
·
it saves postage
·
its easy to sign up for, easy to cancel
·
no lost discounts
Here's how the
Automatic Payment Plan Works:
You authorize your monthly City of Wayne utility payment
to be made from your checking or savings account. Then, just sit back and
relax. The first week of each month you will receive your monthly utility
bill. On the tenth of the month your payment will be made automatically. And
proof of payment will appear with your bank statement.
The authority you give to charge your account will remain
in effect until you notify us in writing to terminate the authorization.
How to apply:
The Automatic Payment plan is dependable, flexible,
convenient and easy. To take advantage of this service, print and complete
the attached authorization form and return it to us.
AUTHORIZATION FOR
AUTOMATIC PAYMENT
I authorize The City of Wayne and the financial
institution named below to initiate entries to my (our) checking or savings
account for utility payments. This authority will remain in effect until I
notify you in writing to cancel notification to be submitted by the 15th of
the month to afford a reasonable opportunity to act on it. Any automatic
payments not honored by the bank will be charged a return check fee.
Name __________________________
City __________________________ State ___________ Zip
__________
Bank Name ____________________________
Bank Routing Number ______________________
Bank Account Number _________________________
Checking ____ Savings ____
Utility Account Number _________________
Signature __________________________________ Date
_____________
Print Name ______________________
Address______________________
Attach a Voided Check or Deposit slip to this form. Authorizations received prior to the 15th
of the month will be set up for automatic payment for the bill due by the
10th of the following month.
Office Use Only
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Date Received _________ By ________
Date Entered ___________
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