Millry Communications
                              PO Box 45
                       Millry, Alabama 36558


                      Direct Payment Plan

Want to save time, checks, and postage?
Then our Direct Payment Plan is for you! You can have your payment deducted automatically from your checking or savings account. And, you won't have to change your present banking relationships to take advantage of this service.

   The Direct Payment Plan will help you in several ways:
• It saves time - fewer checks to write.
• It helps meet your commitment in a convenient and timely manner - even if you're on vacation or out of town.

• No lost or misplaced statements, your payment  is always on time - it helps maintain good  credit.
• It saves postage.

• It's easy to sign up, easy to cancel.

• No late charges.

 


Here's how the Direct Payment Plan works:
You authorize regularly scheduled payments to be made from your checking or savings account. Then just sit back and relax. Your payments will be made automatically on the 10th of each month. Proof of payment will appear on your statement. The authority you give to charge your account will remain in effect until you notify us in writing to terminate the authorization. The Direct Payment Plan is dependable, flexible, convenient and easy. To take advantage of this service, complete the attached authorization form and return it to us.

All you need to do is:
1. Print this page by clicking on the "Print Page" button at the bottom of the form. Follow steps 2 - 6, then mail this form to our business office.
2. Mark the box before the type of account to indicate whether your payment will be deducted from your checking or savings account.
3. Fill in your name, financial institution name, location and date.
4. Attach a voided check for verification of financial institution information.
5. Attach a photocopy of two types of identification. (Driver's license, credit card, etc.)
6. Please check with your financial institution to see if there are charges for processing this direct payment item.

NOTE: Be sure to sign the form!


AUTHORIZATION FOR DIRECT PAYMENT

  I authorize Millry Communications to initiate electronic debit entries to my
    checking account     savings account    
for payment of my phone bill / Internet bill. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law.  If  my automatic debit is not paid due to insufficient funds in my account, I understand that I will be billed a $20.00 insufficient fund charge. This authority will remain in  effect until I have canceled it in writing.

   Please charge my account for the following telephone number(s):
   ______________    ______________    ______________    ______________    ______________

Date________________________________________________________________
Financial institution name (Please print)______________________________________
Account number at financial institution______________________________________
Financial institution routing/transit number ___________________________________
Financial institution city and state__________________________________________
Signature_____________________________________________________________


Source: Direct Deposit and Direct Payment, www.directdeposit.org and www.directpayment.org.