When you use AutoPay, your garbage bill is deducted automatically through your bank account. There is not charge for our customers to use the AutoPay service.

1.  Complete the information requested below. Be sure to choose your payment amount.

2.  Include a voided check (not a deposit slip). We need this to process your request.

Please note: When you mail back this form with a voided check, or with your credit card information we’ll begin deducting your billed amount AFTER your next billing. Please keep making your payment by check until you see “Auto-Pay Acct - Not a Bill” on your statement. This will be located under your name and address on the left side of the top portion of your statement. You will continue to receive a statement from us with the “Auto Pay – Not a Bill” note on your statement. Do Not make any more payments by mail once the “Auto Pay – Not a Bill” note shows up on your statement. On the 15th of the month your payment will be automatically deducted from your bank account or credit card account.

Oregon City, Molalla or Gladstone Garbage Co. ACCOUNT NUMBER ££££££££££

CHECKING ACCOUNT Information

I have included a voided check from my ___ Checking account ___ Savings account

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Name of Bank

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Bank Routing/Transit # (9 digits) Account #

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First Name Last name

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Street Address

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City State Zip code

CREDIT CARD COMPANY Information

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Cardholder’s Signature

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Credit Card Account

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Expiration Date