Village of Trempealeau – Auto Draft Application Form

Trempealeau Municipal Utilities

Trempealeau Municipal Utilities (TMU) coordinates with your bank and automatically withdraws the money for your electric, water, and sewer bill through your bank, savings & loan, or credit union account. - Cancel at any time by notifying us in writing. - You will still receive a normal TMU bill and it will say "Paid Electronically" to show automatic payment. - Payment will be made 20 days after the billing date shown on your bill

Utility Account Number(Required)

Type of Account

Name of Banking Institution

Bank Routing Number(Required)

Bank Account Number(Required)

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

I authorize the financial institution listed to charge my Checking/Savings Account and remit payment for my monthly utility bill to Trempealeau Municipal Utilities.

I authorize Trempealeau Municipal Utilities to estimate a monthly Budget Payment Amount and contact me for enrollment.

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