Manteca, CA · San Joaquin County
Authorization for Automatic Payment of Utility Bill
Manteca utility customers use this form to authorize automatic bank debits for their city utility bills and provide account and banking information.
What this form is
This form authorizes the City of Manteca and the customer's financial institution to debit or correct entries to the bank account listed for utility bill payments. The signer provides banking and contact information, identifies the utility accounts to be debited, and attaches a voided check. The authorization remains in effect until the city receives written notice of termination.
Who needs it
Manteca utility customers who want their bills automatically debited from a checking or savings account should complete and submit this form.
How to submit it
Return the original to the Finance Department at 1001 W Center St, Suite D, Manteca, CA 95337, with a voided check attached. The form also lists [email protected] and fax (209) 923-8930.
About notarization
This document is signed and dated without a notary; attach a voided check, and the signer just signs and dates the authorization.
How to submit this form
- 1
Download The Form
Download the City of Manteca automatic utility bill payment authorization PDF.
- 2
Complete The Form
Select checking or savings and enter the requested banking, contact, and utility account information. Sign and date the authorization.
- 3
Gather Attachments
Attach a voided check. Add a second page if needed to list all accounts to be automatically debited.
- 4
Return The Original
Return the original to the Finance Department at the address printed on the form.
Frequently asked questions
- Do I need a notary for the automatic payment authorization?
- No. This form is signed and dated without a notary. Attach a voided check with the completed authorization.
- How do I submit the automatic payment form?
- Return the original to the Manteca Finance Department at 1001 W Center St, Suite D, Manteca, CA 95337, with a voided check attached. The form also lists an email address and fax number.
- What information does the form ask for?
- It asks for your account type, financial institution and bank account details, contact information, signature and date, and the Manteca utility account numbers and service addresses to be debited.
- What should I attach to the authorization?
- Attach a voided check. The form says to attach a second page if you need more space to list utility accounts.