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Please complete to enroll in Auto-pay with Bank Draft (ACH) or to Stop.
Please note your election to either begin or discontinue ACH draft.
I (we) hereby request and authorize the City of Forney (The Company) to initiate entries to my checking/savings account(s) at the financial institution listed below (The Financial Institution) and, if necessary, initiate adjustments for any transactions credited in error. This authority will remain in effect until The Company is notified by me (us) in writing to cancel it in such time as to afford The Company and The Financial Institution has reasonable opportunity to act on it.
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