Staunton, IL · Macoupin County
Water/Sewer Automatic Pay Plan Enrollment Form
Water and sewer account holders use this form to authorize the City of Staunton to deduct utility payments automatically from a checking or savings account.
What this form is
This form authorizes the City of Staunton to arrange automatic deductions for water and sewer payments from a checking or savings account. Use it to enroll an account in the Automatic Pay Plan; the form requests the account holder’s name, billing address, phone number, water/sewer billing account number, bank routing and account numbers, and signatures. A separate form is requested for each account.
Who needs it
A Staunton water or sewer account holder who wants payments deducted automatically 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 enrollment form is signed and dated without a notary; include a voided check for a checking account, or provide savings-account details.
How to submit this form
- 1
Download the Form
Download the Water/Sewer Automatic Pay Plan Enrollment Form.
- 2
Complete the Enrollment Details
Enter the account holder’s name, billing address, phone number, and water/sewer billing account number.
- 3
Add Payment Account Information
Provide the routing and account numbers; enclose a voided check for checking, or indicate that you are using a savings account.
- 4
Sign and Submit
Sign and date the form, then check the city website for current contact details and submission instructions.
Frequently asked questions
- Do I need a notary for the Water/Sewer Automatic Pay Plan Enrollment Form?
- No. The form has signature and date fields but no notary block. Include a voided check for a checking account, or provide savings-account details.
- How do I submit the Water/Sewer Automatic Pay Plan Enrollment Form?
- The form lists the City of Staunton’s address and phone number but does not specify a submission method. Check the city website for current contact details.
- What information does the form ask for?
- It requests your name, billing address, daytime phone number, water/sewer billing account number, bank routing and account numbers, and signatures.
- Do I need a separate form for each account?
- Yes. The form says to use a separate enrollment form for each account.
Need something notarized?
This Water/Sewer Automatic Pay Plan Enrollment Form doesn’t need a notary — but Illinois residents can notarize other documents online with a commissioned online notary.