Automatic Payment Plan Authorization Form: Fill out & sign online

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Click ‘Get Form’ to open the Automatic Payment Plan Authorization Form in the editor.
Begin by entering your Utility Billing Account Number, Customer Name, Service Address, and Telephone Number in the designated fields.
Next, provide your Financial Institution Name and enter the Routing/Transit Number (9 digit ABA Number) along with your Bank Account Number.
Select your Account Type by checking either 'Checking' or 'Savings'.
For accuracy, attach a voided check or savings deposit slip as instructed.
Indicate your enrollment in the Automatic Payment Plan program by checking the appropriate box.
Finally, sign and date the form to authorize the City of Shorewood to collect payments from your bank account.

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What is an automatic payment form?

Automatic payment options allow you to send payments on a specific day every month. You simply set the amount you want paid and the date you want the money sent. Automatic payments can be a helpful tool for bills that remain constant each month like a mortgage payment, car loan or student loan.

What is a payment authorization form?

A payment authorization form is a formal document that merchants ask customers to fill out when purchasing a product or service that requires future one-time or recurring payments. This is used by subscription-based businesses.

Where do I get an ACH authorization form?

An ACH form must include account details, transaction amounts, frequency, and the account holders signature. You can obtain forms from your bank, download templates online, or use examples provided by financial institutions to ensure compliance with current regulations.

Do I need an ACH authorization form?

Before a business can begin collecting ACH debit payments from a customer, they must receive an ACH debit authorization from them. Theres no standardized format for an ACH authorization form, but each one requires a set of mandatory elements.