Muscle Shoals Electric Board, AL - STOP Bank Draft Authorization

Name on utility bill account: Name on utility bill account: First Last
Phone: Phone: - ### - ### ####
Email:
Address: Address:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
MSEB account number(s):
Bank Name:
Bank account number:
Attach a copy of a voided check:
Date STOP Needed:
Agreement:

Agreement: I hereby authorize MUSCLE SHOALS ELECTRIC BOARD, herinafter called MSEB to stop the debit entry to said checking account indicated. This serves as my written notification to MUSCLE SHOALS ELECTRIC BOARD to STOP the automatic bank draft for said account. I understand that MSEB will need to be notified at least 5 BUSINESS DAYS before the due date to STOP a bank draft.
Draw your signature into the box below:

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.