Lexington, IL · McLean County
Recurring ACH Payment Authorization
Lexington utility customers use this form to authorize recurring monthly payments from a checking or savings account.
What this form is
This form authorizes the City of Lexington to debit a checking or savings account for monthly water, sewer, and garbage service. It asks for billing and utility account information, bank details, and the account holder’s signature and date. The authorization remains in effect until canceled in writing, and the form says changes or termination must be reported in writing at least 15 days before the next billing date.
Who needs it
Lexington utility customers who want to pay their monthly water, sewer, and garbage charges through recurring bank account debits need 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 and dated without a notary; the signer just signs and dates the authorization.
How to submit this form
- 1
Download The Form
Download the Recurring ACH Payment Authorization form.
- 2
Complete The Form
Provide billing and utility account information, select checking or savings, enter bank details, and sign and date the authorization.
- 3
Gather Attachments
The form does not specify any attachments to gather.
- 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 Recurring ACH Payment Authorization?
- No. The form asks the account holder to sign and date the authorization; it does not require a notary.
- How do I submit the Recurring ACH Payment Authorization?
- Submit it to the city department named on the form; check the city website for current contact details.
- What information does the ACH authorization form ask for?
- It asks for billing contact details, utility account number or numbers, checking or savings selection, account and bank names, account number, routing number, and the account holder’s signature and date.
- When does the recurring utility payment occur?
- The authorization states that the monthly utility payment is charged on the 20th of each month. If that date falls on a weekend or holiday, the payment may be executed on the next business day.
Need something notarized?
This Recurring ACH Payment Authorization doesn’t need a notary — but Illinois residents can notarize other documents online with a commissioned online notary.