ContractAch Debit Authorization • February 26th, 2016
Contract Type FiledFebruary 26th, 2016ACH DEBIT AUTHORIZATION AUTHORIZATION AGREEMENT FOR DIRECT PAYMENTS (ACH DEBITS) Company Company Name: ID Number: I (we), hereby authorize City of Poplar Bluff Municipal Utilities, to initiate debit entries to my (our) Checking Account or Savings Account (select one) indicated below at the depository financial institution named below, hereinafter called DEPOSITORY, and if necessary, initiate adjustments for any transactions credited/debited in error. I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of U.S. law. Depository Name: Branch: City: State: Zip: Routing Account Number (9 Digits): Number: This authorization is to remain in full force and effect until Municipal Utilities has received written notification from me (or either of us) of its termination in such time and in such manner as to afford Municipal Utilities and DEPOSITORY a reasonable opportunity to act on it. Name