BILL PAY AUTHORIZATION AGREEMENT

I hereby authorize AMERICAN BANK to debit my account as well as to initiate credit entries (Bill Payments) on my behalf.

I understand that the payments must be initiated at least 7 business days prior to the due date to allow for delivery.

I understand that the payments will not be processed if sufficient funds are not available on the day of the scheduled Bill Payment.

I have received a copy and understand the provisions of the Online Access Agreement.

This authority is to remain in full force and effect until American Bank receives written notification of intent to cancel this agreement. Written notice must be received at least 10 business days prior to the next scheduled credit entry (Bill Payment).

 

 

Name:

 

 

________________________________________________________________________

 

 

Signature:

 

 

________________________________________________________________________

 

 

Date:

 

_______________________      Checking Account: ______________________________

 

Contact:

 ________________________________________ 
Please enter an e-mail address or a phone number so we can contact you once your Bill Pay service has been activated.

 

NOTE:

1. Bill Payments are only allowed from checking accounts.

2. Bill Payments are not allowed from two signer required accounts.

 

Return this form to:

 

FAX:

MAIL:

IN PERSON:

254.799.9463

Attn: AmBank Online

Attn: AmBank Online

P.O. Box 154068

Waco, Texas 76715-4068

200 West Highway 6 (Waco)

OR

1601 North I-35 (Bellmead)