Sign Up for Bank Draft

Name as it appears on BECi account

First Last

BECi Account Number

Phone Number

Name of depositor as appears on bank records

Name of Bank

Bank Routing Number

Checking Account Number

Address of Bank

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

I hereby authorize BECi to draft my bank account each month for my electric utility bill. I agree that the bank’s rights in respect to each draft shall be the same as if it were a check personally signed by me. I understand that the same regulations and authorities exist as though I were paying by check or cash each month. Should my bank dishonor my draft any month, payment by other methods will be demanded and the normal BECi collection procedures will be in effect. BECi may, at any time, revoke this privilege for cause.

This authority shall remain in force until revoked by me or BECi.

Consent

I agree to the all of the terms and conditions.

This agreement shall remain in force until revoked by me or BECi.

Your name below will serve as an electronic signature agreeing to the terms.

First Middle Last

Date of Digital Signature

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Bank Draft Form