Auto Draft Payment Option
Here at H2O4U, not only do we strive to improve the water quality in your home, we would also like to help make life a little easier by offering you our automatic payment option.
To get started, all that you would need to do is fill out this form and return it to us via fax, email or mail.
Please charge/debit my checking or savings account per the account statement/invoice balance on the 15th of each month. This authorization will remain in effect until cancelled by myself in writing.
Name (please print) ________________________________________
Bank Account #____________________________ checking or savings (Circle one)
Bank Routing #_________________________
H2O4U Account #______________________
For those who like to earn points/miles with every dollar they spend, the automatic credit card debit will allow you to do this.
By having your payments automatically charged to your credit or debit card, you can save time, money, and the environment -- no more stamps and envelopes!
You would also have the ease of mind knowing that your payment will never be late.
***Please note: If you are already on automatic payments, do nothing, your status has not changed.
*** Questions? Please call our Billing Department at 800-383-1485.
AUTO DRAFT AUTHORIZATION
Please charge/debit my credit card per the account statement/invoice balance on the 15th of each month. This authorization will remain in effect until cancelled by myself in writing.
Name (please print) __________________________________________ _____
H2O4U Account number_____________________________
CREDIT/DEBIT CARD DRAFT:
Type of Account: Visa Master Card
Name on Credit Card Account____________________________________
Credit Card #: _______________________
Exp. Date: ______________*VIN______________
*The verification code (v.code) for Visa/MasterCard appears on the back of the card and is either the last 3 or 4 digits.
I understand that it is my responsibility to notify your company of expiration date changes.