Automatic Bank Draft Cancellation Form

Complete this form and return to Brunswick Regional Water & Sewer H2Go.

Today's Date:

H2Go Account #:

Effective Date:

Name:

Service Address:

Signature:

* You may fax form to (910) 371-6441 or mail to: H2Go P.O. Box 2230 Leland, NC 28451

** Form must be received by the 25th of the month or the bank draft will be changed the following month.

*** If you are changing banks or bank account numbers, please fill out a new Automatic Bank Draft form.