Budget Payment Plan (BPP)

Budget Payment Plan Application

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Conditions

To complete this application for Budget Payment Plan you must be the authorized account holder and provide your MID account number, email address, and service address.

A MID Customer Service Representative will review your application within 1-2 business days. You will receive an email from customerservice@mid.org confirming the status of your application.

I am the authorized account holder, and I would like to apply for BPP.

Budget Payment Plan

MID Account Number(Required)

Customer Name(Required)

*Must be authorized account contact*

First Last

Customer Email(Required)

Service Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone

Terms(Required)

The account will be removed from the program if there are two missed payments or two returned payments notices in a 12-month period.

Once the account is removed from the program by the District or at the customer’s request, the account will not be eligible to participate in the program for a 12-month period.

The District reserves the right to remove a customer from the BPP program when the customer does not pay the BPP amount and any other fees every month.

When the account is removed from the program, any outstanding balance is due.

The District will not charge or pay any interest on the accrued balance, nor make cash refunds for monies accrued during participation in the BPP program.

I wish to participate in the Budget Payment Plan Program and understand and agree to the terms and conditions listed above. I hereby verify the information to be true and complete. 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.

Customer Electronic Signature (Full Name)(Required)