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Autopay Form

Yes, I want to sign up for the Mishawaka Utilities Autopay plan!

Please fill in the following fields and submit this form once completed. Requests will be processed in the order they are received and could take up to 2 weeks to be completed. Additional information about autopay can be found on our website here: https://mishawaka.in.gov/mu

Name as it appears on your bill*

MU Account Number*

Address Line 1:*

Service Address*

Address Line 2:

City:*

Zipcode:*

Phone Number*

Would you like to receive your bill via email?*

Yes No

Email*

Name of your Bank or Financial Institution

City:*

State:*

Bank City,State

Please attach a voided check

The activation process could take 1-2 weeks to complete.

*ACH guidelines require that the name on your checking account and on your MU account must match.

Date*

Signature