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AUTOMATIC BILL PAYMENT ENROLLMENT FORM IF NOT RETURNING ENROLLMENT FORM WITH A CHECK PAYMENT, PLEASE INCLUDE A VOIDED CHECK. 7426 HUBBARD AVENUE, MIDDLETON, WI 53562 – TELEPHONE. (608) 821-8370 CITY OF MIDDLETON WATER & SEWER UTILITY BILLS NAME ON UTILITY UTILITY ACCOUNT DAYTIME MAILING ZIP NAME OF BANK ACCOUNT BANK ROUTING AUTHORIZED EMAIL ADDRESS: SAVE TIME AND MONEY…. JOIN THE AUTOMATIC BILL PAYMENT PLAN TODAY!! HOW DOES IT WORK? IT’S EASY! JUST COMPLETE THE ENROLLMENT FORM ABOVE, AND RETURN ALONG WITH A VOIDED CHECK. THE CITY OF MIDDLETON WILL CONTINUE TO MAIL YOUR QUARTERLY STATEMENT WITH AN AUTOPAY “DO NOT PAY” MESSAGE ON IT. WHEN WILL THIS TAKE EFFECT? WITH YOUR NEXT BILLING STATEMENT. HOW WILL MY BILL BE PAID? ON THE DUE DATE SHOWN ON YOUR QUARTERLY BILL, THE AMOUNT DUE WILL AUTOMATICALLY BE DEDUCTED FROM YOUR ACCOUNT. HOW CAN I BE SURE MY BILL HAS BEEN PAID? THE PAYMENT WILL APPEAR ON YOUR CHECKING ACCOUNT STATEMENT AS A TRANSACTION TO CITY OF MIDDLETON. IT WILL ALSO APPEAR PAID ON YOUR NEXT BILL FROM US. WHAT IF I WANT TO STOP THE AUTOMATIC PAYMENT PLAN? YOU CAN QUIT THE PROGRAM AT ANY TIME. SIMPLY CONTACT US IN WRITING. ANY QUESTIONS CALL [PHONE REDACTED]. SIGN