Auto-Pay Terms & Conditions
 

BEFORE PROCEEDING, PLEASE NOTE:

  -  If you submit your request to enroll in Auto-Pay before the 15th of the month, Auto-Pay will begin this month.   

  -  If you submit your request to enroll in Auto-Pay on or after the 15th of the month, Auto-Pay will begin next month. 

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Credit Card Auto-Pay Enrollment Form

Cayucos Sanitary District Account #

Service Address

Customer Name

Phone Number

Email (to receive confirmation that your account has successfully been enrolled in Auto-Pay)

Please upload an image of the FRONT of your card by clicking "Choose File" below (required)

Please upload an image of the BACK of your card by clicking "Choose File" below (required)

Zip code associated with card (required)

Attestation (required)

By clicking this button, I understand that I am opting to enroll in Cayucos Sanitary District's Auto-Pay program, which allows for future payments to be automatically charged to my credit/debit card on the 15th of each month, and affirm that I have read and agree to the Terms & Conditions above.

Your Signature (required)

Confirm e-Signature

Review Electronic Records and Signatures Policy (required)

Read our Electronic Record and Signature Disclosure

I agree to use electronic records and signatures

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Now that you've signed up for Auto-Pay....