What does the Bank Enrollment Form do?

It lets a City of Rincon utility account holder authorize periodic payment drafts from a bank account and provide the utility and bank account information.

What must I attach to the form?

Attach a voided check or a copy made in person at City Hall. The form also asks for the utility account details, bank information, and the account holder’s signature and date.

How do I submit the Bank Enrollment Form?

Turn in the form and attachment at City Hall, 302 South Columbia Ave., Rincon, GA 31326. The form says to turn in the information by the 9th for activation for the next payment.

Do I need a notary for the Bank Enrollment Form?

No. The account holder signs and dates the form without a notary; attach a voided check or a copy made in person at City Hall.

Rincon, GA · Effingham County

No notary required

Bank Enrollment Form

Utility account holders use this form to authorize the City of Rincon to draft periodic payments from a bank account.

What this form is

This form lets a utility account holder authorize the City of Rincon to draft periodic payments from a bank account. It asks for the utility account name and number, bank routing and account numbers, and the account holder’s printed name, signature, and date. Attach a voided check or a copy made in person at City Hall. The form states when enrollment information must be turned in for activation.

Who needs it

A City of Rincon utility account holder who wants to enroll the account in automatic bank drafts needs this form.

How to submit it

Turn in the form and a voided check, or a copy made in person at City Hall, at 302 South Columbia Ave., Rincon, GA 31326. The form says information must be turned in by the 9th of the month for activation for the next payment.

About notarization

This document is signed without a notary; the account holder signs and dates the form and attaches a voided check or a copy made at City Hall.

How to submit this form

1
Download The Form
Download the Bank Enrollment Form PDF.
2
Complete The Form
Enter the utility account name and number, bank routing and account numbers, and the account holder’s printed name.
3
Sign And Attach
Sign and date the form, then attach a voided check or a copy made in person at City Hall.
4
Submit To The City
Turn in the form and attachment at City Hall, 302 South Columbia Ave., Rincon, GA 31326. The form states to turn it in by the 9th for next-payment activation.

Frequently asked questions

What does the Bank Enrollment Form do?: It lets a City of Rincon utility account holder authorize periodic payment drafts from a bank account and provide the utility and bank account information.
What must I attach to the form?: Attach a voided check or a copy made in person at City Hall. The form also asks for the utility account details, bank information, and the account holder’s signature and date.
How do I submit the Bank Enrollment Form?: Turn in the form and attachment at City Hall, 302 South Columbia Ave., Rincon, GA 31326. The form says to turn in the information by the 9th for activation for the next payment.
Do I need a notary for the Bank Enrollment Form?: No. The account holder signs and dates the form without a notary; attach a voided check or a copy made in person at City Hall.

Need something notarized?

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