Athens, IL · Menard County
ACH Authorization Form
The City of Athens ACH Authorization Form lets an account holder authorize the city to make entries to a checking or savings account.
What this form is
Use this form to authorize the City of Athens to initiate entries to a checking or savings account and, if needed, adjust transactions credited or debited in error. The form states that payments will come out of the account on the 15th of each month and that authorization remains in effect until canceled in writing. It asks for financial institution and account details, along with the signer’s contact information, signature, and date.
Who needs it
An account holder who wants the City of Athens to make recurring payments 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 document is signed without a notary; the signer just signs and dates the form.
How to submit this form
- 1
Download The Form
Download the City of Athens ACH Authorization Form.
- 2
Complete The Form
Enter the requested financial institution, account, and contact information, then sign and date the form.
- 3
Gather Attachments
The form does not specify any attachments.
- 4
Submit To The City
Submit the completed form to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What does the Athens ACH Authorization Form authorize?
- It authorizes the City of Athens to initiate entries to a checking or savings account and, if necessary, adjust transactions credited or debited in error.
- What information does the form ask for?
- It asks for the financial institution’s name, address, routing number, account number, and the signer’s name, phone number, address, signature, and date.
- How do I submit the Athens ACH Authorization Form?
- Submit it to the city department named on the form; check the city website for current contact details.
- Do I need a notary for the Athens ACH Authorization Form?
- No. This form is signed and dated without a notary.