Sebastopol, CA · Sonoma County
Water & Sewer Direct Debit Authorization
Sebastopol water and sewer customers use this form to authorize automatic payment of their utility bills from a checking or savings account.
What this form is
This form authorizes the City of Sebastopol to debit a customer’s checking or savings account for water and sewer bills. Customers complete it to start direct debit, and must submit a new form if they change bank accounts. It asks for the customer’s name, service address, utility billing account number, phone number, bank routing and account numbers, signature, and date; a voided check must be attached.
Who needs it
Sebastopol water and sewer customers who want utility bills automatically deducted from a checking or savings account need this form.
How to submit it
Submit the signed form with a voided check to the Administrative Services Department in person or by mail, fax it to 707.823.1135, or email it to [email protected].
About notarization
This authorization is signed and dated without a notary; attach a voided check, which the form does not say must be notarized.
How to submit this form
- 1
Download The Form
Download the Water & Sewer Direct Debit Authorization form.
- 2
Complete The Form
Print clearly and provide your customer, service, contact, and bank account information; then sign and date the authorization.
- 3
Attach A Voided Check
Staple a voided check to the lower portion of the authorization. The form says submissions without one will not be accepted.
- 4
Submit To The City
Deliver or mail it to the Administrative Services Department, fax it to 707.823.1135, or email it to [email protected].
Frequently asked questions
- Do I need a notary for the Water & Sewer Direct Debit Authorization?
- No. Sign and date the authorization without a notary. The form requires an attached voided check but does not say that the check must be notarized.
- How do I submit the direct debit authorization?
- Submit it with a voided check in person or by mail to the Administrative Services Department, by fax to 707.823.1135, or by email to [email protected].
- What information does the form ask for?
- It asks for your name, service address, utility billing account number, phone number, bank routing number, bank account number, signature, and date.
- What attachment must I include?
- Attach a voided check to the authorization. The form states that forms submitted without a voided check will not be accepted.