Auto Draft Payment Authorization Form

By enrolling in the Auto-Pay Program, you no longer need to worry about mailing your utility payment each month.

Please note that the form must be signed to authorize the use of your bank information. If you have a bank account but do not have checks, you may still participate in the program by contacting our office.

If you have questions, please call (800) 239-3092.

Account Type (Check one)
Please scan and upload a copy of your driver's license.
One file only.
50 MB limit.
Allowed types: gif, jpg, jpeg, png, svg.
Member Signature

By signing below, I authorize Pioneer Electric Cooperative to draft the stated bank account for the above listed account(s). I understand that it usually takes two billing periods to set up this draft with the bank and that I may need to make the next payment as usual.

Sign above
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