Forms

I (we) hereby authorize THE CITY OF MURPHY, hereinafter called COMPANY, to initiate debit entries to my (our) ( ) checking ( ) savings
account (select one) indicated below at the depository financial institution named below, hereinafter called DEPOSITORY, and to debit the same to such account. AMOUNT OF DEBIT: FLEX EFFECTIVE DATE: 5 DAYS BEFORE IT’S DUE
(This is a flexible amount depending on your monthly bill.) - For Recurring Credit Card payments please click the pdf icon at right

 

Name
Bank Information
City Information


This authorization is to remain in full force and effect until COMPANY has received written notification from me (or either of us) of its termination in such time and in such manner as to afford COMPANY and DEPOSITORY a reasonable opportunity to act on it.