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LAKEWAY MUD NOW OFFERS
"AUTOMATIC CREDIT CARD PAYMENTS"
You are now able to have your water bill paid automatically by charging your credit card with no fees involved. Before we can do this, we need your written authorization. Please fill out the following information, sign and date, and return to the District Office as soon as possible. Your credit card will be drafted up to two (2) business days prior to or after the penalty date. Participation in this program will automatically assure timely payment to avoid penalties. We will still send you a bill so you will know the amount of the charge. It is the responsibility of the customer to notify the District Office of any changes of billing address, expiration date, or type of credit card to be charged.
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AUTHORIZATION AGREEMENT FOR
AUTOMATED CHARGES
(Separate Authorizations for EACH Account Required.)
__________________________________________________________
____________________
Account Name (Last, First, M.I.) [Please Print]
Contact Phone #
______________________________________
________________
Service Address [Street]
Zip Code
I (we) hereby authorize the Lakeway Municipal Utility District to initiate charges to my (our) credit card indicated below.
This authority is to remain in full force and effect until the Lakeway Municipal Utility District has received written notification from me (or either of us) of its termination in such time and in such manner as to afford the Lakeway Municipal Utility District a reasonable opportunity to act upon it.
Name on
Credit Card (please print) ___________________________________________________
If credit card name is
different than customer account name, we must have authorization from cardholder
to complete this transaction.
Credit
Card Number______________________________ 3 (4 for AE) Digit Security Number
______
MANDATORY
Expiration
Date __________________ Card Type: V______ MC______ D______
AE______
V=Visa, MC=
MasterCard, D=Discover, AE= American Express
__________________________________________________ ______________________ Customer Signature Date
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Lakeway Municipal Utility
District
1097 Lohmans Crossing
Lakeway, TX 78734
512/261-6222
512/261-6681 fax
(please call to verify receipt of fax)