Bank Draft Cancellation Request Form : Daphne Utilities

Customer Number*

Customer Name:*

First Last

Service Address:*

Street Address Address Line 2 City State ZIP Code

Contact Phone Number:*

Email Address: (Optional)

Last 4 Digits of the checking/savings account that I wish to remove the automatic draft from*

By submitting this form, I authorize Daphne Utilities to deactivate the automatic bank draft feature on my account. I understand that this change will be in effect within two business days from the date of this request.

Verification

To protect our site and your information against spam bots and to let us know that you are a real human, we have added an extra security measure of verification. Please enter the numbers in the picture above.

For Information on Garbage Services, please visit the City of Daphne's website HERE.

Bank Draft Cancellation Request

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