Automatic Payment Registration

Our automatic payment plan is quick, easy and FREE! Signing up ensures your monthly utility payment will be automatically deducted right from your checking or savings account.

Your payment will be deducted on your bill due date.

Fill out the form below and upload a copy of a voided check (a scanned copy or photo of the check will work), or download the agreement and return the completed form to our office.

Customer Information

Files must be less than 6 MB.
Allowed file types: gif jpg jpeg png pdf.

 Terms and Conditions

  • I authorize Jefferson Utilities to withdraw my payment(s) each month from the checking/savings account shown on my attached voided check.
  • I understand that I may discontinue this payment service at any time by notifying Jefferson Utilities at least five business days prior to the due date of my utility bill.
  • If, at any time, my banking information changes, I will notify Jefferson Utilities in writing with a new voided/scanned check at least five business days prior to the due date.
  • If I do not have sufficient funds in my account on the due date of as bill, I understand that the utility’s current insufficient funds fee will be added to my account.
Type in your name to be used as your e-signature.