Recurring Project Assist Authorization (Auto Pay)

The form below allows AutoPay customers to start, change, or cancel their monthly Project Assist donation. If you have any questions about AutoPay or Project Assist, please contact the Customer Services Division at 602-262-6251.

So that we can best respond to your message, please fill in as much of the following information as possible:

Customer Information

*Name

*Account No (10 digit # on bill):

*Service Address (e.g. 123 E Main St):

*Primary Phone Number

Project Assist Election

You may arrange to donate the same amount each month to Project Asssit if you are already enrolled in the Auto Pay program.

Start a Project Assist monthly donation
Enter amount of donation:
Effective start date (mm/dd/yyyy)

Change my current project Assist donation:
Enter new donation amount:
Date change to be effective (mm/dd/yyyy)

Cancel my recurring Project Assist donation
Effective cancellation date (mm/dd/yyyy) :

Authorization

By completing and submitting this form, I authorize the City of Phoenix to electronically charge my bank account number currently on file for Auto Pay to pay me elected project assist donation on a recurring basis. I understand that I may cancel or change my election by use of this form or by calling customer services at 602-262-6251.

Before you submit this form, please be aware of the city's policy on use of its systems. The message you are about to send is subject to public disclosure under the Public Records Law. It is not private or confidential and is retained for 90 days.

Recurring Project Assist Authorization (Auto Pay)

Customer Information

Project Assist Election

In Person:

By Phone:

About Phoenix

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