Ellaville, GA · Schley County
Automatic Bill Payment Application
Ellaville utility customers use this application to authorize automatic monthly bill payments from a checking or savings account.
What this form is
This application authorizes the City of Ellaville to collect monthly utility bill payments from the applicant’s checking or savings account on the bill’s due date. The name on the utility bill must match a name on the bank account. Applicants provide personal and bank account details, attach a voided check or savings withdrawal slip, and sign and date the form.
Who needs it
Ellaville utility customers who want their monthly bills deducted automatically from a checking or savings account should complete this application.
How to submit it
Complete and sign the form, attach a voided check or savings withdrawal slip, and return it to City of Ellaville, P.O. Box 839, Ellaville, GA 31806.
About notarization
This document is signed without a notary; the signer just signs and dates the application.
How to submit this form
- 1
Download The Application
Download the Automatic Bill Payment Application PDF.
- 2
Complete And Sign The Form
Print the form, enter the requested personal and bank account information, and sign and date it.
- 3
Gather The Attachment
Attach a voided check or savings withdrawal slip.
- 4
Return The Application
Send the completed application and attachment to City of Ellaville, P.O. Box 839, Ellaville, GA 31806.
Frequently asked questions
- Do I need a notary for the Automatic Bill Payment Application?
- No. This document is signed without a notary; the signer just signs and dates the application.
- How do I submit the Automatic Bill Payment Application?
- Complete and sign the form, attach a voided check or savings withdrawal slip, and return it to City of Ellaville, P.O. Box 839, Ellaville, GA 31806.
- What attachment is required with the application?
- Attach a voided check or savings withdrawal slip. The application also says the name on the bill must agree with a name on the bank account.
- What happens after I send the application?
- The city performs a $0.00 pre-note to verify the bank and account numbers. The document says processing may take 1 to 2 billing cycles, and City Hall will contact you when drafts begin.
Need something notarized?
This Automatic Bill Payment Application doesn’t need a notary — but if you have another Ellaville form that does, a commissioned online notary can help.