Rohnert Park, CA · Sonoma County
Authorization Agreement for Direct Payment—ACH
Rohnert Park utility customers use this application to authorize automatic water and sewer bill payments from a checking or savings account.
What this form is
This application authorizes the City of Rohnert Park to debit a checking or savings account for the balance of water and sewer charges on the bill’s due date. Customers choosing ACH payment must provide bank and city account details, service and contact information, a signature, and a date. The city requests a voided check and says the current bill must be received and posted before activation.
Who needs it
Rohnert Park utility customers who want the city to automatically debit their checking or savings account for water and sewer bills need this application.
How to submit it
Return the application with a voided check to the Finance Department at 130 Avram Avenue, Rohnert Park, CA 94928. The current bill must be received and posted before activation.
About notarization
This document is signed and dated without a notary; it asks for a voided check, but does not identify any notarized or sworn attachment.
How to submit this form
- 1
Download the Application
Download the ACH authorization application for Rohnert Park water and sewer utility bills.
- 2
Complete the Application
Provide your bank, account, city account, customer, service address, and phone details, then sign and date the form.
- 3
Gather the Attachment
Include a voided check with the completed application, as requested by the city.
- 4
Submit to the City
Send the application and voided check to the Finance Department at 130 Avram Avenue, Rohnert Park, CA 94928.
Frequently asked questions
- What does the Rohnert Park ACH application authorize?
- It authorizes the city to debit your checking or savings account for the balance of your water and sewer charges on the due date shown on your monthly invoice.
- What should I include with the ACH application?
- The city asks you to return the application with a voided check. The current bill must also be received and posted to your account before ACH service is activated.
- Do I need a notary for the ACH authorization?
- No. Sign and date the application; it requests a voided check but does not identify any notarized or sworn attachment.
- How do I submit this ACH application?
- Send the completed application with a voided check to the Finance Department at 130 Avram Avenue, Rohnert Park, CA 94928.
Need something notarized?
This Authorization Agreement for Direct Payment—ACH doesn’t need a notary — but if you have another Rohnert Park form that does, a commissioned online notary can help.