EZPAY FORM

Yes, I want to sign up for the Mishawaka Utilities EZ Pay plan!

Please fill in the following fields and print out this form. Once you have printed out the completed form, you may choose one of several ways to complete the EZ Pay process:

1. Bring this form into our office at 126 North Church Street,
   Mishawaka across from the Mishawaka Police Station,
   along with a voided check from the checking account you wish to use*; or,
   
2. Fax this form and a copy of a voided check to our office at:
   
                        574-258-1710 or,
   
3. Mail this form along with your voided check to:

Mishawaka Utilities
P.O. Box 363
Mishawaka, IN 46546