E-Z Pay ApplicationClick here for a one page PDF format of this application.Print and mail this application with a copy of your voided check to:Community Water Co. of Green Valley
E-Z Payment Plan AgreementTo join the E-Z Payment Plan, print this form and complete, attach a voided check or savings deposit slip and mail to Community Water Company. A notice of your enrollment in the E-Z Payment Plan will appear on your bill. Please continue to make payments until this notice appears. I hereby authorize Community Water Company and the financial institution designated on this application to charge the account I have specified for payment of my monthly water bill. I have the right to stop payment of a charge by notifying Community Water Company within five days of the billing date. I understand that a fee will be charged to my account for each request returned for insufficient funds. If two requests are returned for insufficient funds, I may be excluded from the plan. In addition, I understand that both the financial institution and Community Water Company reserve the right to terminate this payment plan and/or my participation therein. Should I choose to withdraw from the plan, I will immediately notify Community Water Company. Customer name: ____________________________ Mailing address: ______________________________________________________ Account # :_____________ Service Address: _______________________________ Transit Number: _____________________ Bank Name _______________________ Bank Address: ________________________________________________________ Bank Phone Number _________________________ Checking ___ or Saving ____ Please attach a voided check. Phone number to reach you _____________________ Customer Signature _________________________ Date: _______________ Any questions please call (520) 625-8409 or review our frequently asked questions. |