Washington Electric Cooperative, Inc.
P. O. Box 8, 75 Vt. Rte. 14 N
East Montpelier, Vermont  05651
Telephone 802 223-5245     Fax 802 223-6780

 

* * * AUTOMATIC PAYMENT PLAN AGREEMENT * * *

Name(s): (as shown on electric bill) _________________________________________________________________

WEC Account No: _____________________ Map Location: __________________________

Mailing Address: ________________________________________________________________________________

City: _______________________________State _____________ Zip___________-______

Tenant: __________ or Owner: ___________

Home Phone Number: _______________________ Work Phone: _________________________

Bank Name and Address: _________________________________________________________________________

Bank Phone Number: _____________________

Bank Account Number You Wish Drafted: ___________________________________

PLEASE INDICATE: SAVINGS ________ or * CHECKING __________

                                                           * Include a blank check marked "VOID"

I authorize Washington Electric Cooperative to deduct my monthly electric payment(s) from my indicated account. I understand that I control my payments, and if at any time I decide to discontinue this payment service, I will notify Washington Electric Cooperative in writing.

Authorization Signature(s): ____________________________________________ Date: ___________

                                          ____________________________________________ Date: ___________

Please allow 30-60 days for the Automatic Payment Plan to take effect. Until your electric bill(s) indicates that your payment will be made automatically, please continue to pay the bill(s) as usual.

Once the Automatic Payment Plan is in place, your billing statement will read "BANK DRAFT DO NOT PAY". The amount of the bill will be deducted from your bank account 16 to 20 days after the billing date.

OFFICE USE

Operator Initials:

Date: