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Elk River — AUTOMATIC BILL PAYMENT <br /> Municipal Utilities Saves you Time, Money, and Provides Peace of Mind! <br /> Forget worrying about due dates or late payments when you <br /> have each month's bill paid automatically.Sign up for Elk River <br /> Municipal Utilities Automatic Bill Payment,and breathe easy <br /> knowing your bill is taken care of every month. <br /> SIGN UP NOW AND RECEIVE A <br /> ,, ONE-TIME $5.00 BILL CREDIT! <br /> d <br /> Save Time. <br /> You'll still receive an itemized bill,but won't lift a finger to pay it. <br /> Save Money. <br /> No more cost or hassle of having to pick up stamps. <br /> Peace of Mind. <br /> "..'r Eliminate the worry of missing a payment due date. <br /> PAYING YOUR UTILITY BILL HAS NEVER BEEN EASIER! <br /> Quickly and easily pay your utility bill each month by having it drafted directly from your bank account.Regular <br /> payments will be debited from your bank account on the due date of each month,ensuring your bill is paid on <br /> time,every time.Enrolling is easy, simply fill out the bank draft authorization form below, attach a voided check, <br /> and return to our office at 13069 Orono Parkway, P.O. Box 430, Elk River, MN 55330. <br /> IO bill dit for new customers only.Recurring pf ;,�•F :. - - ERMU's online bill payment system does not qualify. <br /> E <br /> •• <br /> ANK DRAFT AUTHO TION FO ' <br /> I authoriz x�' r icipal Utilities(ERMU)to draft the full amount of my monthly utility bill from the financial <br /> institution listed below on the due date of each month (or on the first business day thereafter).I understand that <br /> ERMU reserves the right to discontinue my Automatic Bill Payment enrollment in the event a payment is returned. <br /> CUSTOMER INFORMATION <br /> Name Utility Account Number <br /> Service Address City State Zip <br /> Phone Number Email Address <br /> Financial Institution Name <br /> Bank Routing/Transit Number Bank Account Number <br /> Account Holder's Signature Date <br /> *TO ENSURE PROPER BANK CODING,PLEASE ATTACH A VOIDED CHECK* <br /> 228 <br />