I authorize Elk River Municipal Utilities (ERMU) to draft the full amount of my monthly utility bill from the financial institution listed below on the 15th of each month (or on the first business day thereafter). I understand that ERMU reserves the right to discontinue my Automatic Bill Payment enrollment in the event a payment is returned. AUTOMATIC BILL PAYMENT Saves you Time, Money, and Provides Peace of Mind! Forget worrying about due dates or late payments when you have each month’s bill paid automatically. Sign up for Elk River Municipal Utilities Automatic Bill Payment, and breathe easy knowing your bill is taken care of every month. SIGN UP NOW AND RECEIVE A ONE-TIME $5.00 BILL CREDIT! Save Time. You’ll still receive an itemized bill, but won’t lift a finger to pay it. Save Money. No more cost or hassle of having to pick up stamps. Peace of Mind. Eliminate the worry of missing a payment due date. PAYING YOUR UTILITY BILL HAS NEVER BEEN EASIER! Quickly and easily pay your utility bill each month by having it drafted directly from your bank account. Regular payments will be debited from your bank account on the due date of each month, ensuring your bill is paid on time, every time. Enrolling is easy, simply fill out the bank draft authorization form below, attach a voided check, and return to our office at 13069 Orono Parkway, P.O. Box 430, Elk River, MN 55330. $5.00 bill credit for new customers only. Recurring payment setup through ERMU’s online bill payment system does not qualify. BANK DRAFT AUTHORIZATION FORM I authorize Elk River Municipal Utilities (ERMU) to draft the full amount of my monthly utility bill from the financial institution listed below on the 15th of each month (or on the first business day thereafter). I understand that ERMU reserves the right to discontinue my Automatic Bill Payment enrollment in the event a payment is returned. CUSTOMER INFORMATION Name Utility Account Number Service Address City State Zip Phone Number Email Address BANKING INFORMATION Financial Institution Name Bank Routing/Transit Number Bank Account Number Account Holder’s Signature Date * TO ENSURE PROPER BANK CODING, PLEASE ATTACH A VOIDED CHECK *

AUTOMATIC BILL PAYMENT96bda424cfcc34d9dd1a-0a7f10f87519dba22d2dbc6233a731e5.r41.… · 2016. 10. 4. · ERMU reserves the right to discontinue my Automatic Bill Payment enrollment

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Page 1: AUTOMATIC BILL PAYMENT96bda424cfcc34d9dd1a-0a7f10f87519dba22d2dbc6233a731e5.r41.… · 2016. 10. 4. · ERMU reserves the right to discontinue my Automatic Bill Payment enrollment

I authorize Elk River Municipal Utilities (ERMU) to draft the full amount of my monthly utility bill from the financial institution listed below on the 15th of each month (or on the first business day thereafter). I understand that ERMU reserves the right to discontinue my Automatic Bill Payment enrollment in the event a payment is returned.

AUTOMATIC BILL PAYMENT Saves you Time, Money, and Provides Peace of Mind!

Forget worrying about due dates or late payments when you have each month’s bill paid automatically. Sign up for Elk River Municipal Utilities Automatic Bill Payment, and breathe easy knowing your bill is taken care of every month.

Save Time.

You’ll still receive an itemized bill, but won’t lift a finger to pay it.

Save Money. No more cost or hassle of having to pick up stamps.

Peace of Mind. Eliminate the worry of missing a payment due date.

PAYING YOUR UTILITY BILL HAS NEVER BEEN EASIER!

Quickly and easily pay your utility bill each month by having it drafted directly from your bank account. Regular payments will be debited from your bank account on the due date of each month, ensuring your bill is paid on time, every time. Enrolling is easy, simply fill out the bank draft authorization form below, attach a voided check, and return to our office at 13069 Orono Parkway, P.O. Box 430, Elk River, MN 55330.

$5.00 bill credit for new customers only. Recurring payment setup through ERMU’s online bill payment system does not qualify.

BANK DRAFT AUTHORIZATION FORM

CUSTOMER INFORMATION

Name Utility Account Number Service Address City State Zip Phone Number Email Address

BANKING INFORMATION

Financial Institution Name Bank Routing/Transit Number Bank Account Number Account Holder’s Signature Date

* TO ENSURE PROPER BANK CODING, PLEASE ATTACH A VOIDED CHECK *