For questions concerning this form or
enrollment into our Bill Payment Service, please call (734) 453-1200 or (877)
937-2328 toll free.
Please note the following requirements:
Community Financial – Bill Payment Service
Application and Authorization
Please return to any branch office, or fax to (734) 582-8905.
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Name:(1) |
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Name:(2) |
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Name:(3) |
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Name:(4) |
_________________________________________________________ |
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Address: |
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City, State, Zip: |
____________________________________________________ |
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Daytime Phone: _______________________ |
Evening Phone: _______________________ |
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Account Number: |
________________ |
E-mail Address: (optional) |
_________________ |
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I/We have read and agree to the terms and
conditions concerning use of Community Financial’s Bill Payment Service. |
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Signature (Name 1) _____________________________________________________________________ |
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Signature (Name 2)
____________________________________________________________________ |
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Signature (Name 3)
____________________________________________________________________ Signature (Name 4)
____________________________________________________________________ Date:
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