Lookout Mountain, GA · Walker County
ACH Authorization Form
This form authorizes the City of Lookout Mountain to draft sewer bill payments from a resident’s checking or savings account.
What this form is
Use this form to authorize the City of Lookout Mountain to initiate payments from a checking or savings account and correct transactions credited in error. It asks for the sewer account and service details, financial institution and account information, and the account holder’s signature and date. The form says to attach a voided check to set up bank draft.
Who needs it
A sewer customer who wants the city to draft bill payments from a checking or savings account should 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 without a notary; attach a voided check to set up bank draft, and the signer signs and dates the authorization.
How to submit this form
- 1
Download The Form
Download the ACH Authorization Form PDF.
- 2
Complete The Form
Enter your sewer account and service details, financial institution information, and checking or savings account details.
- 3
Attach A Voided Check
Attach a voided check to set up bank draft, as directed on the form.
- 4
Sign And Submit
Sign and date the authorization, then submit it to the city department named on the form.
Frequently asked questions
- What does the ACH Authorization Form do?
- It authorizes the City of Lookout Mountain to initiate entries to the listed checking or savings account and, if needed, adjust transactions credited in error.
- What should I attach to the form?
- The form says to attach a voided check to set up bank draft. It also asks for account, service, billing, and financial institution details.
- Do I need a notary for the ACH Authorization Form?
- No. This document is signed without a notary. Attach a voided check to set up bank draft, and sign and date the authorization.
- How do I submit the ACH Authorization Form?
- The form does not provide submission instructions. Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This ACH Authorization Form doesn’t need a notary — but if you have another Lookout Mountain form that does, a commissioned online notary can help.