Do I need a notary for the Automatic Bank Draft Authorization Form?

No. This form is signed without a notary. The customer signs and dates it, and the document does not mention a notarized or sworn attachment.

What information does the form ask for?

It asks for your name, utility account number, bank name, account and routing numbers, first debit date, account type, phone number, signature, and date.

How can I stop automatic bank drafts?

The form includes a termination section. It says to sign that section at least 15 days before the next payment due date; otherwise, the account could still be debited.

Cochran, GA · Bleckley County

No notary required

Automatic Bank Draft Authorization Form

Cochran utility customers use this form to authorize monthly bank drafts for their utility services and provide their account and banking information.

What this form is

This form authorizes the City of Cochran to draft the full amount due for utility services from a customer’s bank account each month. It requests customer, utility account, bank account, routing, payment, and contact information, and requires a copy of a void check. The form also includes a section to revoke the draft authorization.

Who needs it

Cochran utility customers who want to pay their monthly utility bills by automatic bank draft should complete this authorization.

How to submit it

The form lists the City of Cochran at P.O. Box 8, Cochran, GA 31014, and CSR at 112 W. Dykes Street, Cochran, GA 31014. Include a void check copy, not a deposit slip.

About notarization

This document is signed without a notary; the customer signs and dates the authorization, and no notarized or sworn attachment is mentioned.

How to submit this form

1
Download The Form
Download the Automatic Bank Draft Authorization Form PDF.
2
Complete The Authorization
Enter your customer, utility account, bank, payment, and contact information, then sign and date the form.
3
Gather The Attachment
Include a copy of a void check. The form says not to use a deposit slip.
4
Submit The Form
The form lists the City of Cochran at P.O. Box 8 and CSR at 112 W. Dykes Street in Cochran.

Frequently asked questions

Do I need a notary for the Automatic Bank Draft Authorization Form?: No. This form is signed without a notary. The customer signs and dates it, and the document does not mention a notarized or sworn attachment.
How do I submit the Automatic Bank Draft Authorization Form?: The form lists the City of Cochran at P.O. Box 8, Cochran, GA 31014, and CSR at 112 W. Dykes Street, Cochran, GA 31014. Include a copy of a void check, not a deposit slip.
What information does the form ask for?: It asks for your name, utility account number, bank name, account and routing numbers, first debit date, account type, phone number, signature, and date.
How can I stop automatic bank drafts?: The form includes a termination section. It says to sign that section at least 15 days before the next payment due date; otherwise, the account could still be debited.

Need something notarized?

This Automatic Bank Draft Authorization Form doesn’t need a notary — but if you have another Cochran form that does, a commissioned online notary can help.