Cancellation of Automatic Payment Plan By madmin Cancellation of Automatic Payments (ACH) Cancellation of Automatic Payment Plan (ACH) I (We) hereby authorize Sellersburg Utilities to cancel Automatic Payment Plan (ACH) entries to my (our) account indicated below and the financial institution named on the original Automatic Payment Plan (ACH) enrollment form, hereinafter called Financial Institution. Name * Account Number Service Address Service Address Service Address Service Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Date Signature signature keyboard Clear ****Note: All cancellations must be received by the 1st day of the month to be effective for the next billing cycle. Submit
Cancellation of Automatic Payment Plan By madmin Cancellation of Automatic Payments (ACH) Cancellation of Automatic Payment Plan (ACH) I (We) hereby authorize Sellersburg Utilities to cancel Automatic Payment Plan (ACH) entries to my (our) account indicated below and the financial institution named on the original Automatic Payment Plan (ACH) enrollment form, hereinafter called Financial Institution. Name * Account Number Service Address Service Address Service Address Service Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Date Signature signature keyboard Clear ****Note: All cancellations must be received by the 1st day of the month to be effective for the next billing cycle. Submit
