Jesup, GA · Wayne County
Water Service Bank Draft Request Form
Jesup water customers use this form to authorize electronic debits from a checking or savings account for specified amounts and dates or debit frequency.
What this form is
This form authorizes the company identified on it to debit a checking or savings account electronically and, if necessary, credit the account to correct an erroneous debit. It asks for financial institution and account details, authorized amounts and debit dates or frequency, plus the signer’s printed name, signature, and date. Include a void check for verification; the authorization remains effective until revoked in writing.
Who needs it
A water customer who wants to authorize electronic debits from a checking or savings account for specified amounts and dates or frequency needs 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 form is signed and dated without a notary; include a void check for verification and verify ACH routing details with your financial institution.
How to submit this form
- 1
Download The Form
Download the Water Service Bank Draft Request Form PDF.
- 2
Complete The Authorization
Enter the financial institution and account details, authorized debit amounts and dates or frequency, then print your name and sign and date the form.
- 3
Gather The Check
Include a void check for verification and confirm ACH routing details with your financial institution.
- 4
Submit To The City
Submit the completed form to the city department named on it; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Water Service Bank Draft Request Form?
- No. The form calls for the signer’s name, signature, and date, not a notary. Include a void check for verification and verify ACH routing details with your financial institution.
- How do I submit the Water Service Bank Draft Request Form?
- Submit it to the city department named on the form; check the city website for current contact details.
- What information does the bank draft form request?
- It asks for the financial institution, routing and account numbers, account type, authorized debit amounts and dates or frequency, and the signer’s printed name, signature, and date.
- Do I need to include a void check?
- Yes. The form asks you to provide a void check to verify the information and advises checking with your financial institution about the routing number used for ACH processing.
Need something notarized?
This Water Service Bank Draft Request Form doesn’t need a notary — but if you have another Jesup form that does, a commissioned online notary can help.