AUTHORIZATION AGREEMENT

DIRECT PAYMENT (ACH DEBITS)

 

I hereby authorize RURAL ELECTRIC COOPERATIVE to debit monthly entries to my account indicated below and the Financial Institution named below for payment of our electric bill(s).  I acknowledge the origination of ACH transactions to my account must comply with the provisions of the U.S. law.

 

Name of Bank ________________________________________

 

Bank Routing/Transit Number _______________________________

 

Bank Account Number _______________________________

 

 

This authority is to remain in full force and effect until RURAL ELECTRIC COOPERATIVE has received written notice from me of its termination in such time and manner as to afford REC and said Financial Institution a reasonable opportunity to act on it.

 

Customer Name _______________________________________________

 

REC Account Number(s)________________________________________

 

Customer Signature ___________________________________________

 

Date _____________________________

 

Please complete the above information, sign, date and return this form to us along with a VOID CHECK.  We cannot set up on bank draft without the void check.    

 

Rural Electric Cooperative

PO Box 609

Lindsay OK  73052

405/756-3104 or 1/800/259-3504

 

 

FOR OFFICE USE ONLY:

 

BANK #____________________________________

 

 

DATE ENTERED____________________________

 

 

DATE  DRAFT TO BEGIN_____________________