Autopay

If you would like to sign up for the automatic payment plan, please complete the form below and mail/deliver a voided check, or make a back and front copy of your credit card and send to one of the following Gulf Coast Electric Cooperative locations:

9434 North Highway 77
Southport, FL 32409

722 West Highway 22
PO Box 220
Wewahitchka, FL 32465

6243 East Highway 98
Panama City, FL 32404

Automatic Payment Form

Name*
First Last
Email*
Phone*
Last 4 digits of Social Security Number*
Account Number*
Address*
Street Address Address Line 2 City State ZIP Code
Bank Name*
Routing Number*
Bank Account Number*
Member Consent*
I hereby verify the above 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.
I authorize Gulf Coast Electric Cooperative, Inc. to draw monthly bank drafts through the automatic payment plan (ACH) on the account shown below for the payment of my utility bill in full and any other services I authorize. I understand that I may discontinue my participation at any time by notifying Gulf Coast Electric Cooperative, Inc. in writing. Both Gulf Coast Electric Cooperative, Inc. and the bank may terminate this agreement with 10 days' written notice. I understand that Gulf Coast Electric Cooperative, Inc. reserves the right to limit participation in this program to members whose accounts are in good standing. I understand that the amount of my bill each month will be drafted 5 to 7 days prior to my due date. I understand that if funds are not available in my account for the draft to clear that there will be a charge posted to my Gulf Coast Electric Cooperative, Inc. account.
Member Electronic Signature (Full Name)*
Name
This field is for validation purposes and should be left unchanged.