Exeter, CA · Tulare County

No notary required

Utility Direct Payment Authorization Form

This form lets Exeter utility customers authorize the city to deduct full utility bill payments from a checking account.

What this form is

Use this form to enroll in the City of Exeter’s Utility Direct Payment Plan and authorize deductions for the full amount of your utility bill. It asks for your name, utility account number, service address, phone number, bank details, and signature, and requires a voided check. The form says an authorization received after the 10th of the month takes effect in the next billing cycle.

Who needs it

Exeter utility customers who want the city to deduct full utility bill payments from a checking account should complete this form.

How to submit it

Mail it to City of Exeter, Attn: Finance Dept, PO Box 237, Exeter, CA 93221, or drop it off at City of Exeter, Attn: Finance Dept, 137 N. F St, Exeter, CA 93221.

About notarization

No notary is required for this document; the signer just signs and dates the authorization form.

How to submit this form

  1. 1

    Download the Form

    Download the Utility Direct Payment Authorization Form.

  2. 2

    Complete the Form

    Provide your utility account and service details, bank information, and signature and date.

  3. 3

    Attach a Voided Check

    Include a voided check for the checking account listed on the form.

  4. 4

    Submit to the City

    Mail or drop off the completed form and voided check at one of the listed Finance Department locations.

Frequently asked questions

Do I need a notary for the Utility Direct Payment Authorization Form?
No. The signer just signs and dates this form; it does not require notarization.
How do I submit the Utility Direct Payment Authorization Form?
Mail it to the Finance Department at PO Box 237 or drop it off at 137 N. F St, Exeter, CA 93221.
What should I attach to the form?
The form asks you to attach a voided check for the checking account you want payments deducted from.
When does the authorization take effect?
The form states that an ACH form received after the 10th of the month will take effect in the next billing cycle.

Need something notarized?

This Utility Direct Payment Authorization Form doesn’t need a notary — but if you have another Exeter form that does, a commissioned online notary can help.