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City of Shelby Utility Customer
The City of Shelby has implemented a couple of programs whereby a customer may
choose to have their monthly water/sewer/garbage utility bill automatically
debited from their bank account and their utility bill e-mailed to them. The
guidelines for the programs are as follows:
Bills are sent out by the 1st of each month.
Any disputes or questions regarding the bill need to be addressed to the City
of Shelby by the 15th of each month or the next available working day.
On the 20th of each month, or the next available working day, and if there is
no change in billing status or amount, your bank account will be debited for the
amount shown on your bill.
Any changes will require completion of a new authorization form.
Any account that does not have the required funds available will be charged a
$25.00 NSF fee, plus any additional bank fees by the City of Shelby.
You can also sign up for paperless billing by having your utility bill
e-mailed to you. Just fill in your e-mail address on the form below. Leave blank
if you don’t want this option.
To sign up for the automatic debit program, complete the attached form and
return it to:
City of Shelby
112 1st St So
Shelby, MT 59474
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ELECTRONIC FUND TRANSFER PAYMENT-AUTHORIZATION FORM
This is my (our) authorization of my (our) bank, named below, to deduct from my
(our) account as identified below and pay to the City of Shelby the amount of my
monthly utility service bill. This authorization will remain in effect until
written notice of cancellation is received either by my (our) bank or by the
City of Shelby.
NAME:____________________________________
as it appears on your bank account
Bank Name:__________________________ Address:___________________________________
Routing No:__________________________ Account
No:________________________________
Signature:______________________________________________ Date:_________________
as you sign your checks
e-mail address:______________________________________________________for
paperless billing
You may also attach a blank, voided check so we can verify the necessary routing
and account numbers.
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FOR OFFICE USE ONLY:
Account Number: _______________ Date Changed: __________ Initials: _________
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