Ponderosa Auto-Pay Enrollment Form

I authorize PONDEROSA TELEPHONE and the financial institution named below to deduct the amount of my monthly telephone bill from my bank account. I understand my automatic payment will be deducted on the 10th business day of each month. I understand that both PONDEROSA TELEPHONE and my financial institution reserve the right to terminate this authorization and my participation therein. If I choose to terminate this authorization, I will immediately notify PONDEROSA TELEPHONE. By signing this enrollment form, I confirm that I have reviewed and accepted the Terms and Conditions of the Ponderosa Auto-Pay service.

    Customer Information:
    Name:
    Address:
    City/St/Zip:
    Ponderosa account to be paid:
    Ponderosa account to be paid:
    Daytime Phone:
    Bank Draft Information:
    Name of Financial Institution:
    Phone:
    Please deduct payments from:
    Checking. You must provide us with a voided check.
    Savings. You must provide us with:
    1. Bank Routing/Transit Number:
       
    2. Savings Account Number:
       
Signature Required*:_________________________________ Date:______________

*Must be an authorized signer for the account(s) identified above
and match the name on the voided check.

 & Mail to:


Ponderosa Telephone
Attn: Customer Care
P.O. Box 21
O'Neals, CA 93645

Questions? Call Customer Care at 559-868-3312.

© 2006 Ponderosa Telephone Company.  All Rights Reserved.  Ponderosa Internet and Ponderosa Long Distance are subsidiaries of Ponderosa Cablevision; an affiliate company to Ponderosa Telephone Company. 

        

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