NJ - Payment Options - 4-panel - December 2014

to our many
customers for
choosing to go
green with EFT
and paperless
70,000+ customers
Number of customers who pay
their bill automatically through
our Electronic Fund Transfer
program. No paper required!
Made Easy
$5.88 in
Printed on paper containing recycled content. Each ton of recycled paper saves 7,000 gallons of water.
24,000 customers
Number of New Jersey customers who
receive their bill electronically.
No paper required!
(Keep in mind, we’ve only been offering this
program to our customers for about a year.)
Cost to
use these
Sign up for both of these programs on
My H2O Online at www.amwater.com/myh2o.
We offer several convenient options,
including automatic payment and
paperless billing!
Payment Options
Automatic Payment Program Authorization
We offer six convenient payment options.
Choose the one that fits your needs the best!
(Please print name as shown on bill)
1 Pay Automatically.
Name ___________________________________________________
Billing Address ____________________________________________
City______________________State_______Zip ________________
Save time and money. Sign up for
our Electronic Fund Transfer (EFT),
and your bill will be paid on time,
a year in
every time, directly from your
checking or savings account on
the date it is due. No stamps
required. You will still receive a copy of your bill
before the due date, so you will have time to ask
any questions before payment. Best of all, it’s
totally free! To enroll in the program, log on to
My H2O Online at www.amwater.com/myh2o
or contact our customer service center.
For service to (if different than above) ________________________
City______________________State_______Zip ________________
Phone Number (______) ____________________________________
New Jersey American Water Account Number__________________
To participate in New Jersey American Water’s Electronic Fund
Transfer Program, I ________________ authorize New Jersey
American Water Company to instruct my financial institution
named below to make my water bill payments from the
following account as they are due:
2 Pay by mail
Using the envelope provided with your bill.
No cash, please.
3 Pay your bill online*
Visit www.water.paymybill.com. Be sure to have
your account number handy.
4 Pay by phone*
Checking Account
Checking Account Number: _____________________________
Routing Number: ______________________________________
See sample below if you’re not sure where these are.)
Savings Account (*No passbook accounts please.)
Savings Account Number:_______________________________
I understand that I am in full control of the automatic payment
service. If I decide to discontinue it, I will notify New Jersey American Water. Please allow 30 days to process your request.
I understand this information will be used solely for the
purposes of the automatic payment service.
24-hours a day, every day at 1-866-271-5522.
Be sure to have your account number handy.
5 Pay in person
Please note: a handling fee may be applied for insufficient funds
or returned checks. Note for commercial accounts: Commercial
account requests must be accompanied by a statement from the
account holder’s bank on bank letterhead indicating that the signature on the form is the approved signature for the commercial
account at the bank. This letter must be signed by a bank officer.
Account Holder Name (please print) _________________________
Signature ________________________________________________
Date ____________________________________________________
For a listing of authorized payment locations, call
or visit us online at www.amwater.com/myh2o.
John Doe
123 Main St.
Anywhere, NJ 17000
6 Pay Through a Third Party
If someone handles paying your bills, such as a
relative, trustee or social service organization,
we can send a copy of your bill, as well as any
reminder, past-due and shut-off notices, to that
third party.
*There is a third-party fee per transaction for
credit card or e-check payments.
Date ______________
No Stamps Required.
Check Routing Number
Account Number
Please mail your completed form to:
New Jersey American Water, P.O. Box 578, Alton, IL 62002
You may also fax this form to 1-618-433-4569.