Authorization Agreement for Automatic Bill Payment

With the Automatic Bill Payment Plan, payments are automatically posted to the member’s checking account or debit / credit card.  This is a free service. When on this plan, a monthly electric bill will be mailed to the member that states “Bank Draft - Do Not Pay” or “Credit Card - Do Not Pay.”  When the payment date falls on a weekend or holiday, the withdrawal will be processed on the following business day. {Form #75, 02/13/2015, kjg}


Select only one of the following automatic bill payment options - Checking Account  OR Debit/Credit Card. The necessary information, documentation and signatures must be provided.

*A voided or photocopy of the member’s check must be provided. *It may take up to 30 days for bank features to be effective for automatic bill payment.
One file only.
100 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

The electric bill payment will be posted on the 3rd of each month.

Last 3-digit or 4-digit number on back side of debit / credit card


This Authorization Agreement will be in effect with submission of this completed form with the required signature(s), which authorizes Consumers Energy to initiate debit entries to the checking account or   debit / credit card referenced. If the member account is a joint account, this Authorization Agreement must have both signatures. The designated depository bank / card issuer is authorized to debit the payment amount to the cooperative’s member account. This agreement will be in force until cancelled by the member or Consumers Energy. By providing your full legal name in signature field here, you acknowledge that the form is accurate and binding (pending accurate completion of all other form sections). It is not necessary to print and sign the form if users plan on submitting the form electronically. I agree that my electronic signature on this agreement/document has the same effect as a signature signed in ink.

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