Virden, IL · Macoupin County
Authorization Agreement for Direct Payments (ACH Debit)
Virden Water Department customers use this authorization to allow monthly water bill debits from a checking or savings account.
What this form is
This agreement authorizes the City of Virden Water Department to debit a designated checking or savings account for water payments. The form says the account will be debited on the 16th of every month and that the authorization remains in effect until written termination notice is received. It asks for depository details, routing and account numbers, names, signatures, and dates.
Who needs it
Virden Water Department customers who want their water payments debited from a checking or savings account should complete this authorization.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details. The form names the Virden Water Department.
About notarization
This document is signed without a notary; the signer just signs and dates it on the authorization.
How to submit this form
- 1
Download The Form
Download the Authorization Agreement for Direct Payments (ACH Debit) for Virden Water Department customers.
- 2
Complete The Account Details
Select checking or savings and enter the depository information, routing number, account number, name, signature, and date.
- 3
Gather Attachments
The form text does not identify any attachments to gather.
- 4
Submit To The Department
Submit the signed authorization to the Virden Water Department; check the city website for current contact details.
Frequently asked questions
- What does the Virden direct payment authorization do?
- It authorizes the City of Virden Water Department to debit a checking or savings account for water payments. The form states that debits occur on the 16th of every month.
- What information does the form ask for?
- It asks for the depository name and branch, city, state, ZIP code, routing number, account number, names, signatures, and dates.
- Do I need a notary for the direct payment authorization?
- No. This document is signed without a notary; the signer just signs and dates the authorization.
- How do I submit the authorization?
- Submit it to the Virden Water Department. The form does not provide a submission address or other contact details, so check the city website for current information.