Automatic Payment Plan Application

Our Automatic Payment Plan allows you to have your electric bill automatically deducted from your checking or savings account on the 17th of each month. It's always on time and you don't need checks, envelopes or stamps! We will deduct the net amount shown on your bill and proof of payment will appear on your monthly statement. This form must be received, with a VOIDED CHECK or DEPOSIT SLIP by the 20th of the month prior to the month you wish payments to begin.

Menard Electric Cooperative
PO Box 200
Petersburg, Illinois 62675


Name: SSN:
Address:
City: State: Zip:
Phone #:
Map Location #: (Upper Right Corner of Bill)
Bank Name:
Bank Account #:
Type Of Account: Checking Savings
Authorization Statement: I authorize Menard Electric Cooperative to draw monthly bank drafts through the automatic plan (ACH) on the account shown above for the payment of my electric bill in full and any other services I authorize. I understand that I may discontinue my participation at any time by notifying Menard Electric Cooperative in writing. Both Menard Electric Cooperative and the bank may terminate this agreement with 10 days written notice. I understand that Menard Electric Cooperative reserves the right to limit participation in this program to customers whose accounts are in good standing. I understand that the amount of my bill each month will be drafted on the 17th or next business day after. I understand that if funds are not available in my account for the draft to clear, there will be a charge posted to my Menard Electric Cooperative account, for NSF, and I will still be required to make full payment before the due date of the bill.
Signature of Applicant: Date:
Please print out and mail in this form with a voided check or deposit slip.

View Site Map 		Menard Electric Cooperative
14300 State Hwy 97
PO Box 200
Petersburg, IL 62675-0200
(800) 872-1203 or (217) 632-7746
Email - info@menard.com 		Copyright 2011-2013 All Rights Reserved by
Menard Electric Cooperative and AgPage Int. Consulting, LLC