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TROPHY CLUB
` MUNICIPAL I
UTILITY
DISTRICT
TROPHY CLUB MUNICIPAL UTILITY DISTRICT No. 1
Bank Draft Authorization Form
Trophy Club Municipal Utility District No. 1 is hereby authorized to draft my bank account on the due date
of each month for my monthly utility bill. I authorize my financial institution indicated below to debit such
amounts from my bank account. Automatic drafts returned by your financial institution for insufficient
funds will be charged back to your account and assessed a service fee of $25.00. I understand that
automatic draft may take up to two billing cycles to take effect and that a message will appear on my bill
when the draft will begin.
WATER BILL INFORMATION
Name on Account:
Service Address:
Utility Account No:
Phone No.: ( )
BANK INFORMATION (attach a VOIDED blank check to this form)
Name of Financial Institution:
Address of Financial Institution:
Bank Routing No.:
Account No.:
I understand that this authority shall remain in effect until written notification is received by the District.
Signature: Date: / /
SUBMIT THIS FORM BY:
EMAIL: UB@tcmud.org
FAX: 817-491-9312
MAIL: 100 Municipal Dr. • Trophy Club, TX 76262
TCMUD1 Bank Draft Authorization Form 02-2021