Bank Draft Cancellation Request Form : Daphne Utilities

Bank Draft Cancellation Request

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.
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