Autopay Sign UpAuthorization FormCustomer InformationName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*JCREMC Auto Pay Enrollment Check here to enroll your JCREMC account in Auto Pay.JCREMC Account NumberJCFiber Auto Pay Enrollment Check here to enroll your JCFiber account in Auto Pay.JCFiber Account NumberPayment InformationPayment Type* Checking SavingsBank Name*Routing Number*Please enter your 9-digit routing number.Account Number*ConsentI hereby authorize JCREMC to process my monthly electric bill payments as they are due via automated payment according to my preferences indicated above. I understand that I have full discretion of the EZ Power Pay payments and have the right to discontinue enrollment in the EZ Power Pay program at any time by providing JCREMC with written notification. JCREMC, the financial institution named, and the credit card company reserve the right to terminate this payment plan and/or my participation in the program. Yes, I agreeCAPTCHANameThis field is for validation purposes and should be left unchanged.
