After providing the above information, please return this form with your voided check or savings account deposit slip to the Main Office of Okeechobee Utility Authority.

I authorize Okeechobee Utility Authority to automatically initiate charges (debit entries) to my bank account as indicated herein, and for my bank to accept and post such charges for the payment of all bills rendered to me by Okeechobee Utility Authority

I understand that Okeechobee Utility Authority will be required to irretrievably send the request for direct debit to the bank approximately two (2) to five (5) business days prior to the actual draw.

I understand that Okeechobee Utility Authority will continue to send me a monthly statement. Each month on the bill’s due date, my bank account will be charged. Okeechobee Utility Authority will impose a processing fee in the event a charge is not paid by the bank.

I understand that I may discontinue this payment service by notifying the Main Office of Okeechobee Utility Authority in writing, before the next billing cycle is completed. I further understand that, if the account deposit amount is based on the direct debit service, the account deposit may be required to be upgraded should the direct debit service be terminated.

Please allow two weeks for your application to be processed. Please continue to pay your bill as you normally would until you see a notation on your bill that payment has been made from your checking account by direct debit.

Please sign and date this form if you agree to accept these terms as stated above.