Don’t like to worry about paying your electric bill on time or writing that check? Sign up for our Direct Pay option today! Step 1 of 3 0% Member InformationName(Required) First Last Account Number(Required) Address(Required) Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Home PhoneMobileWork Phone Bank Account or Credit Card InformationBank Account or Credit Card?(Required) Bank Account Credit Card Financial Institution Name(Required) Branch(if applicable) Address(Required) City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Transit / ABA Number(Required) Account(Required) Checking Savings Bank Account Number(Required) Credit Card Number(Required) Expiration Date(Required) Card Type(Required) Visa Mastercard Member Agreement & ConsentMember Authorization & Consent(Required) I hereby verify the information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.I (we) hereby authorize Barton County Electric Cooperative, Inc., herinafter called COMPANY, to initiate debit entries to my (our) credit card or checking/ savings account indicated above and the financial institution named above, hereafter called DEPOSITORY, and to debit the same to such account. I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of U.S. law. This authorization is to remain in full force and effect until COMPANY receives written notification of cancellation 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. All entries initiated hereunder are to be governed in all repsects by the rules of the National Automated Clearing House Association. I recognize that I must notify COMPANY of any changes in financial institution or account to ensure proper and timely deposit to my account.Member Electronic Signature (Full Name)(Required) CancellationCancellation I hereby cancel the authorization for COMPANY to originate Direct Payment entries to my checking/savings account indicated above, effective on the date below.Date (mm/dd/yyyy) Month Day Year Member Electronic Signature (Full Name)