AUTHORIZATION TO PAY
ELECTRIC BILL BY BANK DRAFT

Date to be deducted from account: *

Bank Information

Type of Account *

Account number
The second set of numbers following the character symbol immediately after your routing number is your account number. Sometimes the placement can be switched with the check number. To determine your account number, simply choose the longer number.

Routing number
The first set of numbers on the lower left corner of a check is the routing number. The routing numbers are 9-digit codes and the character symbol surrounding the numbers is not part of the routing number on a check.

check numbers

FINANCIAL INSTITUTION PAYMENT PLAN FOR ELECTRIC ACCOUNTS
I (we) hereby authorize United Electric Cooperative, Inc. to pay and to charge my (our) account. I (we) further authorize the Financial Institution named above to pay my monthly bills on the date specified above of each month, or the next working day if it falls on a weekend by charging each payment to my account. This authority is to remain in effect until revoked by me in writing. Until you receive and have had reasonable time to act on such notice, you shall be fully protected in honoring any United Electric Cooperative, Inc., debit against my account. I (we) understand, however, that both the Financial Institution and United Electric Cooperative, Inc., reserve the right to terminate this payment plan (or my participation therein).

NOTE TO FINANCIAL INSTITUTION
United Electric Cooperative Inc., is instructed to forward this authorization to you. If the information on this document does not agree with your record, or if this arrangement is not in keeping with your procedures, please call the United Electric Office.