East Goshen Township Electronic Debit Program Form
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1East Goshen Township Electronic Debit Program
The Township is happy to announce that they have implemented an electronic debit
program for payment of sewer and refuse bills. This program is an electronic system that
automatically pays your township utility bill. Once you are enrolled in this program your
quarterly sewer and/or refuse payment will be automatically deducted from the bank
account you provided us.
More great news…There is no charge for this program! It is absolutely free.
Residents enrolled in the program will be sent a notification at the beginning of each
quarter giving approximately 30 days advance notice of when the money will be
th
withdrawn from their bank account. Deductions occur quarterly on February 20
, May
th
th
th
20
, August 20
, and November 20
(if those dates fall on a weekend the deduction will
occur on the next business day). Enrollment may be revoked at any time upon written
notice to the Township to discontinue automatic payments.
Please call the Township at 610-692-7171 and ask to speak with Tia Piccolo at extension
3105 if you have any questions. Additional applications can be obtained at the Township
Building.
************************************************************************
East Goshen Township
Payment Authorization for Electronic Debit Program
Name:
____________________________________________________________
Address:
____________________________________________________________
____________________________________________________________
Phone:
____________________________________________________________
Financial Institution: _____________________________________________________
Bank Account Number: ___________________________________________________
Signature:
____________________________________________________________
************************************************************************
I authorize East Goshen Township to instruct my banking institution to make my sewer
and/or refuse payments from the account listed above. I understand this authorization
may be removed by me at any time by providing East Goshen Township with a written
notice to discontinue my automatic payments.
Please submit voided check with application to:
East Goshen Township
1580 Paoli Pike
West Chester, PA 19380
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