Direct Payment Form

What is Direct Payment

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.

How do I enroll?

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 "accounts@inetnebr.com" or phone (402) 434-8680 (Lincoln) or (402) 592-1110 (Omaha).

Direct Payment Plan Enrollment Form

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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.