La Verne, CA · Los Angeles County
Auto Pay Direct Debit Enrollment Form
La Verne Municipal Service account holders use this form to authorize automatic deductions from a bank account for water and sewer bills.
What this form is
This form lets eligible La Verne Municipal Service account holders authorize automatic payment of their water and sewer bills from a bank account. Complete it to enroll in Auto Pay, then return it with your next payment and provide one of the listed proofs of your bank account and routing numbers. Keep making payments until your bill states “Auto Pay.”
Who needs it
La Verne Municipal Service account holders who meet the stated eligibility conditions and want water and sewer bills deducted automatically from a bank account need this form.
How to submit it
Complete the form and return it with your next payment to the City of La Verne, 3660 D Street, La Verne, CA 91750; keep paying until your bill states “Auto Pay.”
About notarization
This form is signed and dated without a notary; include one listed proof of the bank account and routing numbers, and the authorized account holder signs the form.
How to submit this form
- 1
Download The Form
Download the Auto Pay Direct Debit Enrollment Form for La Verne.
- 2
Complete The Form
Enter your account, service address, customer and bank details, then sign and date the authorization.
- 3
Gather Bank Proof
Include a voided blank check, a bank screenshot showing account and routing numbers, or a bank letter confirming both.
- 4
Return The Form
Return the form with your next payment to the City of La Verne at 3660 D Street, La Verne, CA 91750.
Frequently asked questions
- Do I need a notary for the Auto Pay enrollment form?
- No. The form is signed and dated without a notary. Include one listed proof of your bank account and routing numbers, and have the authorized account holder sign.
- How do I submit the Auto Pay enrollment form?
- Complete the form, include one of the listed bank-account proofs, and return it with your next payment to the City of La Verne at 3660 D Street, La Verne, CA 91750.
- What proof of my bank account should I include?
- Include a blank check marked “VOID,” a screenshot from your bank showing the account and routing numbers, or a letter from your bank confirming both numbers. Balances and transaction history may be redacted.
- When will my automatic payment be deducted?
- The payment is deducted on the due date shown on your utility bill. Continue making payments until your bill states “Auto Pay.”