|
SIGN UP FOR AUTOMATIC BILL PAYMENT
|
|
Please complete and return this form with a voided check: I authorize the City
of Atlantis to instruct my bank/savings institution to make my utility
payments from the account listed below. I understand that I control my
payments and if at any time I decide to discontinue this service, I will
notify the City of Atlantis Utilities. I further understand that items
returned unpaid for any reason are subject to a $25.00 fee. Customer Name (As shown on bill) _________________________________________ Service Address _________________________________________________________ Signature __________________________________ Daytime Telephone _____________ Financial Institution _______________________________________________________ Account Number__________________________________________________________ Routing Number__________________________________________________________
|
|
City of Atlantis
Utilities |