Enjoy the easy, reliable, and safe convenience of Clarke Electric Cooperative's automatic bill payment plan.
Your authorization gives you:
- Advance Notice
of Payment-About 18 days before your account is charged, you will receive
your electric and/or Internet bill.
If you have questions about your bill just call your local office at 641-342-2173.
- Proof of Payment-The amount deducted for payment will be shown on your monthly bank statement.
AUTHORIZATION AGREEMENT FOR AUTOMATIC PAYMENTS
I (We) hereby authorize Clarke Electric Cooperative to initiate debit entries (charges) to my (our) checking or savings accounts as indicated below and the Depository Financial Institution named below, to charge the same such account. The initial authorization is for a variable amount to be charged to my account on the due date printed on the bill for the monthly electric and/or Internet service presented by Clarke Electric Cooperative. Giving any of the undersigned notification, Clarke Electric may change the billing date from time to time.
Click here to print this form.
When filling out this
form, please print clearly
| Bank
Name__________________________
City_______________________State___________ Zip Code_______ Bank Transit/ABA No.__________________ Bank Acct No.___________________ To pay by recurring Credit/Debit Card, please complete the information below: Exp Date
_____/_____ _____ VISA
_____ MC Signature of Cardholder_______________________________________________ This authority is to remain in full force and effect until Clarke Electric Cooperative, Inc., has received written notification from me (or either of us) of its termination in such time and in such manner as to afford my financial institution a reasonable opportunity to act on it. The customer has the right to stop payment of a charge by timely notification to the institution prior to charging the account. The Customer may rescind any charge within 15 days after notice of posting has been sent to the Customer. Name______________________________________________ Date________________ Electric Account Number___________________________ Signature______________________________ Spouse____________________________ Please
attach a voided check or deposit slip |