Monticello, IL · Piatt County
City Utility Services Automatic Withdrawal Authorization Form
Monticello City Utility Services customers use this form to authorize electronic debits from a bank account for utility payments.
What this form is
This form authorizes the City of Monticello and the financial institution named on it to initiate electronic debit entries and adjust debit entries made in error. It asks for customer and service details, utility account information, bank details, account type, and a signature and date. The authorization remains in effect until canceled in writing at least 15 calendar days before the next billing period.
Who needs it
A City of Monticello City Utility Services customer who wants to authorize utility payment withdrawals from a checking or savings account needs 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 form is signed and dated without a notary; it does not identify any attachment or related step that must be notarized or sworn.
How to submit this form
- 1
Download The Form
Download the City Utility Services Automatic Withdrawal Authorization Form PDF.
- 2
Complete The Form
Enter your customer, service, utility account, and bank information, then sign and date the form.
- 3
Check For Attachments
The form does not list any required attachments.
- 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
- Do I need a notary for the City Utility Services Automatic Withdrawal Authorization Form?
- No. The form asks for a signature and date, not notarization. It does not identify any attachment or related step that must be notarized or sworn.
- How do I submit the automatic withdrawal authorization form?
- The form does not provide submission instructions. Submit it to the city department named on the form; check the city website for current contact details.
- What information does the authorization form ask for?
- It asks for your name, service address, phone, email, City Utility Services account number, financial institution, routing and account numbers, account type, signature, and date.
- How can I cancel the withdrawal authorization?
- The form says to cancel in writing at least 15 calendar days before the next billing period. It also says to notify City Utility Services as soon as possible if your account details change.
Need something notarized?
This City Utility Services Automatic Withdrawal Authorization Form doesn’t need a notary — but Illinois residents can notarize other documents online with a commissioned online notary.