Daly City, CA · San Mateo County
Authorization Agreement for Direct Payments (ACH Debits)
Daly City water and garbage customers use this form to authorize automatic bill payments from a checking or savings account.
What this form is
This form authorizes the City of Daly City to collect water and garbage charges automatically from a customer's checking or savings account. Customers provide bank and account details, utility account information, contact details, and signatures. Processing may take up to eight weeks, so customers remain responsible for paying bills until notified that direct payments are active.
Who needs it
Daly City water or garbage customers who want their bills paid automatically from a checking or savings account need this form.
How to submit it
Return the completed form to the Utility Billing Division, City of Daly City, 333 – 90th Street, Daly City, CA 94015, or email it to [email protected].
About notarization
This document is signed without a notary; the signer just signs and dates it.
How to submit this form
- 1
Download The Form
Download the Authorization Agreement for Direct Payments (ACH Debits).
- 2
Complete The Form
Enter the requested bank, utility account, contact, and authorization information.
- 3
Sign And Date
Provide the printed name, signature, daytime phone number, and date requested on the form.
- 4
Submit To Utility Billing
Return the completed form by mail to the address printed on it or email it to [email protected].
Frequently asked questions
- Do I need a notary for the Direct Payments (ACH Debits) form?
- No. This form is signed without a notary; the signer just signs and dates it.
- How do I submit the Direct Payments (ACH Debits) form?
- Return it to the Utility Billing Division at the address printed on the form, or email the completed form to [email protected].
- What information does the ACH form request?
- It requests the depository bank name, branch, checking or savings account type, routing and account numbers, utility account number, printed name, signature, daytime phone number, and date.
- How long can setup take?
- The form says processing may take up to eight weeks. Continue paying bills until you are notified that direct payment is in place.
Need something notarized?
This Authorization Agreement for Direct Payments (ACH Debits) doesn’t need a notary — but if you have another Daly City form that does, a commissioned online notary can help.