What does the Direct Debit Authorization Agreement authorize?

It authorizes the City of Bunker Hill to withdraw the amount shown on the monthly statement for water and sewer charges at the listed service address.

What information does the agreement ask for?

It asks for the customer's name, water account number, service address, bank name, routing and account numbers, preferred withdrawal date, signature, and date.

Do I need a notary for the Direct Debit Authorization Agreement?

No. This agreement is signed and dated without a notary; the document does not mention a notarized or sworn attachment.

How do I submit the Direct Debit Authorization Agreement?

The document does not state a submission address or department. Submit it to the city department named on the form; check the city website for current contact details.

Bunker Hill, IL · Macoupin County

No notary required

Direct Debit Authorization Agreement

Bunker Hill water and sewer customers use this agreement to authorize automatic withdrawals from a checking account for monthly charges.

What this form is

This agreement authorizes the City of Bunker Hill to withdraw the amount shown on the customer's monthly statement for water and sewer charges at the listed service address. It asks for customer and water account details, bank name, routing and account numbers, a preferred withdrawal date, and the customer's signature and date. The agreement remains in effect until the city receives written termination notice.

Who needs it

Water and sewer customers who want the City of Bunker Hill to withdraw monthly charges automatically from a checking account need this agreement.

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; the signer just signs and dates the agreement.

How to submit this form

1
Download The Agreement
Download the Direct Debit Authorization Agreement PDF.
2
Complete The Agreement
Enter your customer and water account details, service address, bank information, and preferred withdrawal date; sign and date the form.
3
Gather The Referenced Attachment
The agreement refers to a voided check attached to identify the financial institution.
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 Direct Debit Authorization Agreement authorize?: It authorizes the City of Bunker Hill to withdraw the amount shown on the monthly statement for water and sewer charges at the listed service address.
What information does the agreement ask for?: It asks for the customer's name, water account number, service address, bank name, routing and account numbers, preferred withdrawal date, signature, and date.
Do I need a notary for the Direct Debit Authorization Agreement?: No. This agreement is signed and dated without a notary; the document does not mention a notarized or sworn attachment.
How do I submit the Direct Debit Authorization Agreement?: The document does not state a submission address or department. Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

This Direct Debit Authorization Agreement doesn’t need a notary — but Illinois residents can notarize other documents online with a commissioned online notary.