Cancellation of Bank Draft
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I authorize Mallory Valley Utility District to stop the automatic bank draft of the following account:
Date
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Customer Name
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Service Address
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Mallory Valley Account Number
Name of Bank
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Bank Account Number
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Customer Signature
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The automatic bank draft will be stopped before this account is drafted for the next billing cycle. This institution is an equal opportunity provider, and employer.
I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authroized to represent.
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