Automated Payments

Customer Application Form / Checking Account

Save time & money by signing up for our new Automatic Payment Plan (APP). For your convenience, we can now automatically deduct your monthly bill from your checking account. No more checks to write! No more bills to open. No more stamps to lick. Simply complete the information below and attach a voided check.

PLEASE ATTACH A VOIDED CHECK TO THIS FORM AND MAIL TO : HALL OIL & PROPANE, INC. ATTN: AUTODRAFT DEPT., 1254 N MAIN ST, WALNUT COVE, NC 27052

NOTE: If you bank at a Credit Union, you must verify with your institution the correct bank routing and account numbers for use with pre-authorized drafts on your account.

I hereby authorize a bank draft from the account designated below, not to exceed the amount/budget payment due, to Hall Oil & Propane according to products and services delivered by Hall Oil & Propane.

 

Sign _____________________ Date __________

You must check one (one only) of the next three (3) options and sign/date above.

О    I would like for Hall Oil & Propane, Inc. to automatically draft my fuel payment from this account.

О    I would like for Hall Oil & Propane, Inc. to automatically draft 12 (one per month) equal payments from this account.  Monthly Payment $             

О    I would like for Hall Oil & Propane, Inc. to automatically draft 4 (one per quarter) equal payments from this account. Quarterly Payment $            

Everything below is to be filled in by Hall Oil & Propane Inc. from data on voided check.

Banking Information

Name of Primary Bank Name of Account
Bank Representative Bank Phone Number
Bank Routing Number Bank Account Number

For Office Use Only.

Start Date: _________/__________/_________ Starting Balance: $_______________________

Payment Requested: $_____________ + N/A_% Service Chrge: $____Free______________

= Total Monthly/Quarterly Draft Amount $ _____________________