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Authorization Agreement for Automatic Payments (ACH Debits) 2026
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- Click ‘Get Form’ to open the Authorization Agreement for ACH Automatic Payment in the editor.
- Begin by entering your name as it appears on your bank account in the 'Customer Information' section.
- Fill in your mailing address, including city, state, and zip code. Ensure accuracy for seamless communication.
- Provide your daytime phone number for any necessary follow-up regarding your application.
- If your service/account address differs from your mailing address, include that information in the designated field.
- Locate and enter your utility account number, which can be found on your bill.
- In the 'Financial Institution Information' section, input the name of your financial institution along with the checking ABA routing number and checking account number from the bottom of your check.
- Attach a voided check by uploading it directly through our platform to ensure accurate processing.
- Review the authorization statement carefully before signing and dating it at the bottom of the form.
- Finally, submit the completed form either by mailing it to the City of Painesville Utilities Office or emailing it along with the scanned voided check.
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See more Authorization Agreement for Automatic Payments (ACH Debits) versions
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2021 | 4.8 Satisfied (131 Votes) |
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Related links
Processing transactions through the Payflow service does not affect or define the time periods of authorizations, See the Payflow ACH Payment Service Guide for
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