HomeYour AccountPayment & BillingPayment ServicesAutomatic Bank Draft Form Font Size: Share Share on FacebookShare on X (Twitter)Share on PinterestShare on LinkedinShare on Email Feedback Print Automatic Bank Draft Form Account Type Personal Business Business Name(Required)Name(Required)Your name as shown on electric bill First Last Checking Account Number(Required)Name of Bank and Branch(Required)E-mail address(Required) Do you want a paperless-statement? Yes No Depositor's signature(Required)I authorize Appalachian Electric Cooperative to debit my bank account monthly by Automated Clearing House for the amount of my electric bill, due and payable to Appalachian Electric Cooperative. I further agree that AEC shall be under no obligation to furnish me with any special advice or notice in writing or otherwise of the charging of same to my account. Until AEC receives my revocation of this authorization in writing, I agree that AEC shall be fully protected in honoring any such electronic debit to my account. *If choosing paperless option please include e-mail address for $1 a month credit on your bill. AEC is an equal opportunity provider and employer I hereby authorize my elecric bill to be paid by my bankPhone Number(Required)Date (MM/DD/YYYY)(Required) Month Day Year AEC Account Number(Required)Please provide to AEC a voided check on the account to be drafted(Required) Drop files here or Select files Accepted file types: gif, jpeg, jpg, pdf, png, Max. file size: 400 MB. Note to bank: If the information on this form does not agree with your records, or if the arrangement is not in keeping with your procedures, please contact Appalachian Electric Cooperative, P. O. Box 710, Jefferson City, TN 37760. Telephone: Toll-Free: 833-489-0606 All information submitted in this form has AES-256 encryption to protect your personal information.CAPTCHA
HomeYour AccountPayment & BillingPayment ServicesAutomatic Bank Draft Form Font Size: Share Share on FacebookShare on X (Twitter)Share on PinterestShare on LinkedinShare on Email Feedback Print
