ACH Bank Draft Payments

If you would like the ease and convenience of automatic bank draft to pay your monthly bill, sign up with the PDF form below. Your account will be drafted on the 15th of each month. If the 15th falls on a Saturday, Sunday or Holiday, funds will be drafted the next business day. There are no extra fees for this option!

Print off the form, fill out and sign, attach a voided check (if you do not have checks or planning not to get checks we will need proof of routing & checking account number from the bank or from online banking. You can return this form to the office by mail 1506 Old Highway 50 Williamsburg, KS 66095 By Fax 785-746-5529 Or by email [email protected]

There is a $15.00 return fee from our bank for, Non-Sufficient Funds, Stop Payment Requests, & Acct. Closed or Frozen. 

Related Documents