Electronic Funds Transfer Authorization
Electronic Funds Transfer Authorization

Electronic Funds Transfer (EFT) Authorization Agreement for Utility bill payments to the City of Yuba City.

This service is free of charge, easy to use, and a convenient way to pay your utility bill, allowing you to:

1. Get rid of the check writing chore. 2. Make payments on time, even when you are away from home. 3. Save on postage, checks, and envelopes. 4. Continue to receive monthly statements confirming account balances.

If you need any help or questions regarding the Electronic Funds Transfer (ETF), please call (530) 822-4618, Monday through Friday during regular business hours.

 

Last Name:  

First Name:   Middle Initial:  

Customer Account Number:  

Service Address:

Apt #:

City: State:

Zip Code:

Mailing Address:

Apt # 

City: State:

Zip Code:

Daytime Phone (with area code)  

Evening Phone (with area code) 

Name of Financial Institution:

Financial Institution Branch Office:

Checking Account Number:  

or Savings Account Number:

ABA / Routing Number:      

Would you like your utility bill mailed to you?   YES   NO 

Your Name as shown on Financial Institution Records:

I hereby authorize the City of Yuba City to deduct funds from my account at the above indicated financial institution to pay my utility bill on the fifteenth of the month prior to the due date shown on my bill.  I understand that I may stop the electronic funds transfer service by notifying the City of Yuba City and my financial institution in writing, two weeks prior to my next billing cycle.  If necessary, my financial insitution may also discontinue participation.  I further understand that electronic funds transfer program may be automatically cancelled.  Additionally, payments returned due to insufficient funds are subject to return check fees and late payment penalties.

By authorizing the City of Yuba City to deduct funds from my account, I acknowledge that payment of my utility bill remains my sole responsibility.  I agree and understand that the City of Yuba City cannot be responsible for any failures of my financial institution to transfer funds, failure of mine to maintain sufficient funds in the paying account, or for any failure of transfer due to problems arising from the electronic funds transfer system.

I, the (applicant) for this Electronic Funds Transfer (ETF), warrant the truthfulness of the information provided in this application.

Electronic Signature: (printed name)

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above terms
 



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