Southern Indiana Power My Account Payment & Billing Autopay Program Form Font Size: Share Share on FacebookShare on X (Twitter)Share on PinterestShare on LinkedinShare on Email Feedback Print
Autopay Program Form Autopay Program "*" indicates required fields Name* First Last Southern Indiana Power Member Account Number*Mailing Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Cell Phone*Alternate PhoneEmail Bank Draft*CheckingSavingsCheck Image (front only)*Accepted file types: jpg, png, pdf, Max. file size: 30 MB. Drop files here or Select files Max. file size: 128 MB. Routing Number*Account Number*Bank Name*Consent*I, authorize Southern Indiana Power to draw monthly bank drafts on my bank account shown above for the payment of my monthly electric bill. I understand that I may discontinue my participation in Autopay by notifying the cooperative in writing. Both Southern Indiana Power and the bank may terminate this agreement with ten (10) days written notice. I understand that the cooperative reserves the right to limit participation in Autopay to customers whose accounts are in good standing. I agree to the privacy policy.Applicant Electronic Signature (Full Name)*Date* MM slash DD slash YYYY Security Check
