Dublin, GA · Laurens County
Bank Draft Authorization Form
Dublin utility customers use this form to authorize automatic bank withdrawals for monthly utility bill payments and provide their account information.
What this form is
This form authorizes the City of Dublin to debit a bank account for monthly utility bill payments, and it remains in effect until the customer signs a discontinuation request. It asks for applicant and utility account details, bank routing and account numbers, a Social Security number, and a signature and date. The form must be completed in full, with a voided check attached, to begin the draft.
Who needs it
Dublin utility customers who want their monthly bills paid automatically from a bank account need to complete this form.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed and dated without a notary; attach a voided check to begin the bank draft.
How to submit this form
- 1
Download The Form
Download the Bank Draft Authorization Form.
- 2
Complete The Form
Fill in the applicant, utility account, bank account, and Social Security information, then sign and date it.
- 3
Gather Attachments
Attach a voided check to begin the bank draft.
- 4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What does the Bank Draft Authorization Form do?
- It authorizes the City of Dublin to automatically debit a bank account for payment of a monthly utility bill. The authorization stays active until the customer signs a discontinuation request.
- What must I include with the form?
- Complete the form in full and attach a voided check to begin the bank draft. The form requests applicant, utility account, bank account, and Social Security information, plus a signature and date.
- Do I need a notary for the Bank Draft Authorization Form?
- No. The form is signed and dated without a notary; attach a voided check to begin the bank draft.
- How do I submit the Bank Draft Authorization Form?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Bank Draft Authorization Form doesn’t need a notary — but if you have another Dublin form that does, a commissioned online notary can help.