What does the Electronic Draft Authorization Form do?

It enrolls a customer in automatic drafts for a utility bill or lets the customer specify changes to an existing account.

Who can enroll in the electronic draft program?

The form says the designated bank account must be in the customer’s name, their spouse’s or dependent’s name, or a person responsible for their finances.

Do I need a notary for the Electronic Draft Authorization Form?

No. The form is signed and dated without a notary. A voided check is required for any new account, and no notarized or sworn attachment is stated.

How do I submit the Electronic Draft Authorization Form?

Return the completed form to the Utility Billing office in City Hall. Include a voided check if you designate a new account.

Vienna, GA · Dooly County

No notary required

Electronic Draft Authorization Form

Vienna utility customers use this form to enroll in automatic monthly bank drafts or to change the account used for utility bill payments.

What this form is

The form enrolls a customer in the City of Vienna’s Electronic Draft program or records changes to an existing account for automatic utility bill payments. It requests customer and billing details, bank name and address, routing and account numbers, and a signature and date; a voided check is required for any new account.

Who needs it

Vienna utility customers who want automatic monthly drafts or need to change the bank account used for their utility bill can complete this form.

How to submit it

Return the completed form and, for any new account, a voided check to the Utility Billing office in City Hall.

About notarization

This form is signed and dated without a notary; attach a voided check for any new account, and no sworn or notarized attachment is stated.

How to submit this form

1
Download The Form
Download the Electronic Draft Authorization Form PDF.
2
Complete The Form
Enter your customer and billing information, bank details, and signature and date.
3
Gather Attachments
Attach a voided check if you designate a new account.
4
Submit To The City
Return the form and any required voided check to the Utility Billing office in City Hall.

Frequently asked questions

What does the Electronic Draft Authorization Form do?: It enrolls a customer in automatic drafts for a utility bill or lets the customer specify changes to an existing account.
Who can enroll in the electronic draft program?: The form says the designated bank account must be in the customer’s name, their spouse’s or dependent’s name, or a person responsible for their finances.
Do I need a notary for the Electronic Draft Authorization Form?: No. The form is signed and dated without a notary. A voided check is required for any new account, and no notarized or sworn attachment is stated.
How do I submit the Electronic Draft Authorization Form?: Return the completed form to the Utility Billing office in City Hall. Include a voided check if you designate a new account.

Need something notarized?

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