Please Note

• A copy of a cancelled or voided check is required.
• Account balance must be $0.00 to be set up.
• There are NO convenience fees attached to this type of payment.

Agreement & Disclosure Statement

Record of Payment

You will continue to receive a utility bill indicating the amount to be debited to your bank account. The following utility bill will show your automatic payment. Your monthly bank statement will indicate the amount and date of your automatic transfer. Retain this record as proof of payment. If a question arises regarding your transfer, of if the amount differs from your bill, you must notify the City of Collinsville’s Finance Department and your financial institution immediately.

Payment Date

The predetermined amount will be transferred from your checking/savings account on the due date. You are responsible for any fees charged by your bank that is associated with non-sufficient funds. In addition, the City of Collinsville charges a $25 fee for NSF’s. Auto-Pay may be cancelled if two (2) payments are returned within a 12-month period.

Termination

Automatic debit service will remain in effect unless the City of Collinsville receives written notice from you 30-days prior to the cancellation date or until your service is terminated with the City of Collinsville.

Account/Address Change

Please notify the Finance Department of any account or address changes as soon as possible.