How does Direct Debit work?
Direct Debit lets you authorize the payment of your
utility bill directly from a checking account or credit
card. In other words, your check writing days are over!
Direct Debit means you won’t have to worry about late
payment fees or bother with envelopes, stamps and
mailboxes again.
How will I know how much is being deducted?
You’ll still receive a copy of your bill. If you have
questions about specific charges, simply contact the
City of Horseshoe Bay. Otherwise, your bill will be
paid automatically.
When will my bill be paid?
For both the “Checking Account Debit” and e “Credit
Card Debit” option, payment automatically takes place
approximately five (5) business days after you receive
your bill.
What do I save with Direct Debit?
Since your bill is paid automatically, you save on check
charges, postage and, most importantly, time.
What if I later decide I do not want Direct Debit?
Simply notify us in writing and we will discontinue
your enrollment.
How do I put Direct Debit to work for me?
Just complete and return the Application (a voided
check is required for checking account debit).
Is there a charge for Direct Debit?
No.
What if I have multiple bills from the City of
Horseshoe Bay?
You will need to fill out an application for each account
you have. Please call a customer service representative
at 830-598-8741 if you have any questions.
Please complete the “Direct Debit Application” section and then sign the “Authorization Agreement”. Next,
complete EITHER the “Credit Card Debit” or “Checking Account Debit” section. If you choose the “Checking
Account Debit” option, include a voided check and mail back to the City of Horseshoe Bay.
Please continue to pay your bill as usual until a message appears on your bill stating that the bill will be
paid by Direct Debit.
I would like to pay by (check one) Credit Card Checking Account
DIRECT DEBIT APPLICATION (This Section to be completed on ALL Applications)
Name (as shown on bill) Last _____________________________ First _________________________
Account Number _________________________
Physical Address ____________________________________________
Billing Address _____________________________________________
City ___________________________ State _____________ Zip Code _______________
Authorization Agreement
I hereby authorize The City of Horseshoe Bay and the financial institution designated in this application to charge
the account/credit card I have specified for payment of my monthly service. I understand that a $25.00 fee will be
charged to my account for each request returned for non-sufficient funds. If two requests are returned for non-
sufficient funds, I will be excluded from participation in plan. In addition, I understand that both the financial
institution and The City of Horseshoe Bay reserve the right to terminate this payment plan and/or my participation
therein. At any time, I may elect to discontinue my enrollment in this plan. If I so choose, I will provide written
notice upon receipt of my bill to the City of Horseshoe Bay.
Signature ___________________________________ Date ______________ Phone _______________
PLEASE SELECT ONE OF THE FOLLOWING OPTIONS:
Credit Card Debit
Card Type: Visa Mastercard Pin #_____________
Account Number*________________________________ Exp. Date* ______________
Name (as it appears on your card) ___________________________________________
Billing Address __________________________________________________________
City ___________________________ State _____________ Zip Code _______________
Checking Account Debit
Financial Institution ___________________________________________________________________
Address ______________________________________________________________________
City ___________________________ State _____________ Zip Code _______________
Account Name (as it appears on your checks) _______________________________________
Account Number * ________________________________
Include a voided check from your account. Make certain you check is marked VOID
*To avoid a late notice/charge, it is your responsibility to inform the City of Horseshoe Bay of a change in
expiration date or account number.
Issued: 4/15/2015
CITY OF HORSESHOE BAY
DIRECT DEBIT APPLICATION
