DIRECT DEBIT APPLICATION
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 will not have to worry
about late payment fees or bother with envelopes, stamps, and mailboxes
again!
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.
How will I know how much is being deducted?
You will 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.
What if I later decide I do not want Direct Debit?
Simply notify us in writing and we will discontinue
your enrollment.
When will my bill be paid?
For both the “Checking Account Debit” and the “Credit Card Debit”
option, payment automatically takes place approximately five (5)
business days after you receive your bill.
How do I put Direct Debit to work for me?
Just complete and return the Application (a void
check is required for checking account debit).
What do I save with Direct Debit?
Since your bill is paid automatically, you save on check charges, postage
and, most importantly, time.
Is there a charge for Direct Debit?
No.
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)
DIRECT DEBIT APPLICATION (This Section to be completed on ALL Applications)
Last ______________________________________
First ______________________________
Account Number ______________________________________________________
Physical Address ________________________________________________________________________________________
Billing Address _________________________________________________________________________________________
City ____________________________
State________________________
Zip _____________________________
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 $35.00 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 the 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 _____________________________
Phone _______________________
PLEASE SELECT ONE OF THE FOLLOWING OPTIONS:
Exp. Date ______________________________
Name (as appears on card) ____________________________________________
* Account No. _____________________
Billing Address __________________________________________________________________________________________
City _________________________________
State _______________________________
Financial Institution ______________________________________________________________________________________
Address ________________________________________________________________________________________________
City __________________________________
State ___________________________
Account Name (as it appears on your checks) ________________________________________________________________
* Account No. ________________________________________________________________________________________
Include a voided check from your account. Make certain your 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 exp. date or
account #.
