Set up Direct Payment with Midway Telephone Company

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Direct Payment

You can pay your Telephone Bill directly out of your bank account by filling out the form below and submitting it on-line or you can print it out and send it to our office.

It will usually be done on the next months billing cycle. You will still receive a monthly statement but it will have direct billed do not pay stamped on it.

AUTHORIZATION FOR DIRECT PAYMENT

I authorize the Midway Telephone Company and the financial institution named below to initiate entries to my checking or savings account. This authority will remain in effect until I notify you in writing to cancel it in such time as to afford the financial institution a reasonable opportunity to act upon it. I can stop payment of any entry by notifying my financial institution 3 days before my account is charged.

Bank Information


Name of financial institution:
Branch:
City:
State:	Zip Code:
Bank Telephone Number:
Account Number:
Financial Institution Routing Number:
Account Type:

(Contact your bank for the Nine Digit Routing Number)

Customer Information
Name:
Address:
City:
Telephone Number:
Today's Date:
Please print a copy of this after e-mailing and retain for your records.