To set up your Epayment please fill out the form and press the Submit button.

RESIDENT INFORMATION

*First Name:  *Last Name: 
*E-mail Address: 
*Phone Number: 

*Your Billing Address (where bank and credit card statements are mailed to you)

*City:  *State:  *Zip Code: 

PROPERTY/COMMUNITY INFORMATION
*Property/Community Name:
*Apt/Condo Unit: 
Submeter Solutions Account Number. (If known): 


AUTOMATED CLEARING HOUSE (ACH) PAYMENT OPTION
(check box to select this option)
Bank Name: 
Bank Routing Number: 
Bank account Number: 


DEBIT/CREDIT CARD PAYMENT OPTION (check box to select this option)
Card Number: 
Expiration Date:   Security Code: 


ONE TIME EPAYMENT (CREDIT CARD ONLY)
Payment Amount:  (account balance if left blank)

RECURRING MONTHLY EPAYMENT
If Recurring Monthly Payment Option is Selected,
Payment End Date: 
(Note, if Payment End Date is left blank, a Recurring Monthly EPayment will be process until canceled)

Recurring Payment Amount charges will be total monthly utility charge as noted on bill plus convenience fee


SUBMETER SOLUTIONS UTILITY EPAYMENT TERMS AND CONDITIONS

AUTHORIZATION
I hereby authorize Submeter Solutions to process payment of my utility bill electronically as stipulated above.  If I have selected on-going monthly Epayments, I acknowledge that it is my responsibility to notify Submeter Solutions when I wish to cancel these payments.

*Name:  *Date: 
(Enter name and date above. Entering name and date authorizes EPayment transactions)