You may also download the Autodraft Form (PDF). Sandhill Account Number(Required) Name as Shown on Sandhill Account(Required) First Last Name of Financial Institution(Required) Name as Shown on Financial Institution Records(Required) First Last Autodraft from Bank Account or Credit Card(Required) Bank Account Draft Credit Card Draft Bank Account Type(Required) Checking Savings Routing Number(Required) Account Number(Required) Credit Card Type(Required) Discover MasterCard Visa Card Number(Required) Expiration Date (mm/yy)(Required) Note: You will continue to receive your bill as normal each month. Allow 1 to 2 billing cycles for draft to begin.Consent(Required)I hereby authorize Sandhill Telephone Cooperative Inc. and its subsidiaries, hereafter called COMPANY, to electronically debit my account on the 12th of each month (and, if necessary, to credit my account to correct erroneous debits) as specified at the depositary financial institution named below. I agree that ACH transactions I authorize comply with all applicable law. Amount of debit shall be the amount as indicated on the monthly billing statement. I understand this authorization will remain in full force and effect until I notify COMPANY in writing that I wish to revoke this authorization. I understand COMPANY requires at least 5 business days prior notice in order to cancel this authorization. I hereby verify the information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.Electronic Signature as Accepted by Financial Institution (Full Name)(Required) CommentsThis field is for validation purposes and should be left unchanged.