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AUTOMATIC PAYMENT PLAN (APP)
CITY OF SELAH
115 W. Naches Ave.
Selah, WA 98942
Take it easy with the City of Selah’s Automatic Payment Plan (APP). This convenient plan will give you peace of mind and save you the cost of buying stamps. When you enroll in the plan you will receive your monthly utility bill as usual. Instead of writing a check and mailing your payment, or driving to City Hall to make your payment, you simply enter the amount of the payment in your checking account register. With the APP, your bank account is automatically debited on the day that your payment is due so you can be assured that your utility bill will be paid on time every month. Electronic transactions are protected by federal regulation. You may cancel the APP by contacting the City of Selah by at least the 15th day of the month in which you desire to discontinue participation.
To sign up for the Automatic Payment Plan (APP) please fill out the form below and return it to the City of Selah along with a voided check. (If you have multiple utility accounts you wish to enroll in the APP, attach a listing of those accounts.)
AUTOMATIC PAYMENT PLAN AUTHORIZATION AGREEMENT
I (we) hereby authorize the City of Selah to automatically withdraw from my (our) bank account identified below the amount due on my (our) monthly billing statement(s) for the utility account(s) listed below. I (we) authorize the Financial Institution listed below to accept such withdrawals initiated by the City of Selah. The withdrawals shall be made from my (our) bank account on the 20th day of each month, or the next working day if the 20th falls on a weekend or holiday.
Utility Account No(s): _____________________________
Customer Name(s): _________________________________________________
Service Address(es): ________________________________________________
Financial Institution: _________________________________________________
Branch: __________________ Checking Account No: _________________________
Transit/Routing No. ______________________
(First 9 numbers of the encoded line at bottom of check)
This authorization is to remain in effect until the City of Selah and the Financial Institution have received notification from me of termination. I (we) understand that such notification must be received by the City of Selah by the 15th day of the month in which I (we) desire to terminate participation. I am (we are) aware of my (our) right to stop payment of a withdrawal by notifying the Financial Institution at any time up to 3 business days before the withdrawal date. If a withdrawal is refused by my (our) Financial Institution due to insufficient funds, my (our) utility account will be assessed a $ 20.00 NSF fee.
SIGNATURE(s): __________________________ ___________________________
Answers to Frequently Asked Questions Concerning the Automatic Payment Plan:
May I have a withdrawal made from my savings account?
At this time the City of Selah only allows withdrawals from financial accounts which can issue checks.
May I pick a date other than the 20th for the payments to be withdrawn from my checking account?
At this time payments may only be deducted on the due date of the 20th. If the 20th falls on a weekend or holiday the deduction will occur on the next working day.
May I terminate my participation in the APP at any time?
You must contact City utility billing staff by the 15th of the month in which you desire to terminate participation.