Internet Nebraska offers a Direct Payment Plan. Direct payment is an efficient electronic payment alternative to paper checks. Instead of you writing a check, your bank will automatically make the payment on a predetermined date. It's that simple. Direct payment is easier for you -- your bank, instead of you, will worry about paying us each month -- and it reduces our operating costs, which enables us to continue offering high- quality services at low prices. You retain total control of your account and payments, and Internet Nebraska provides you notice of all charges. Customer satisfaction is a high priority at Internet Nebraska -- we are members of the Better Business Bureau, and you have our personal guarantee that we work to resolve all problems, including billing problems, to our customers' satisfaction.
To enroll in the Direct Payment Plan, simply complete and return the following enrollment form. Please include a VOIDed check from your account to provide routing information. If you have any questions about Internet Nebraska's Direct Payment Plan, please send e-mail to "firstname.lastname@example.org" or phone (402) 434-8680 (Lincoln) or (402) 592-1110 (Omaha).
------------------------------------------------------------------------------ I authorize Internet Nebraska to initiate variable debit entries to my account identified below in payment for Internet services. I authorize my financial institution identified below to debit my account for these payments. I understand that I am in full control of my payment, that I have the right to hold or stop an electronic payment simply by giving my financial institution timely notice, and that I may revoke this authorization at any time by notifying Internet Nebraska. I will notify Internet Nebraska of any changes in the information provided on this authorization form. Signature______________________________________ Date__________________ Name _______________________________________________________________ Address_______________________________________________________________ City _____________________________ State______ Zip__________________ Phone Number__________________________________________________________ Username (login)______________________________________________________ Financial Institution_________________________________________________ Address_______________________________________________________________ City _____________________________ State______ Zip__________________ Account Name (on checks)______________________________________________ Federal Reserve Routing Number________________________________________ Account Number________________________________________________________ (The Federal Reserve Routing Number is the first number in the lower-left corner of your check. It appears between the |: and |: symbols and is usually 9 digits. Your Account Number is the next number. It appears between the second |: and the ||' symbol. Do not include the Check Number, which follows the ||' symbol.) Return this form to: Internet Nebraska PO Box 5301 Lincoln NE 68505-5301 Include a VOIDed check to confirm routing code information.