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Utility Service Agreement Form

I hereby authorize the Town of Spring Hope to draft my monthly utility bill payment from the bank account specified below.  I have submitted a voided check as the proof of my account existence.  I understand that if my account is drafted and the funds are not available, there will be a $30 declined draft fee added to my bill.  There will only be one draft per month.  If the funds are not available on that day, I will submit payment to the Town of Spring Hope or risk disconnection of services.  If I fail to submit payment and my utility services are disconnected, I understand that I must pay the entire amount due on my account plus a reconnection fee of $50.00.  


In order to be removed from this service, I agree to notify Spring Hope Town Hall 30 days prior to the date from which I would like to be removed.  


If my utility services are permanently de-activated, I understand that my total final bill amount will be drafted out of the specified bank account on the 15th of the following month. 

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