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Direct Debit Enrollment Form
If you sign up for Direct Debit, the amount due on your bill will be automatically deducted from your checking account 20 days after your bill is prepared each month. Starting with your next energy bill, youll be notified in advance of the amount and date of the deduction, so you can record it in your checkbook.
Printer Friendly Version To activate Direct Debit, simply print the following enrollment form and fill it out. Then mail the form with a voided check so we can record the correct banking information to:
Delmarva Power
Remittance Processing
5 Collins Drive, Suite 2048
Carneys Point NJ 08069
I authorize Delmarva Power to automatically debit my bank account monthly under the Direct Debit Plan. I understand that this agreement may be terminated by me at any time by written or verbal notification to Delmarva Power. Any incorrect charges will be corrected upon notification to Delmarva Power. If corrections are necessary, it may result in a credit or debit to my checking account.
(Please sign below exactly as your name(s) appears on your checking account.)
Authorized Signature ___________________________________________
Date _______________
Direct Debit Enrollment Form
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Delmarva Power Account Number
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Customer Name
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Customer Address
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City, State, Zip
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Daytime Phone
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Financial Institution Information
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Checking Account Number
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Bank Name
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Routing Number
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City, State, Zip
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Bank Phone
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