Pawnee, IL · Sangamon County
Direct Debit Enrollment
Pawnee utility customers use this form to enroll in monthly automatic payments from a checking or savings account.
What this form is
This form lets a Village of Pawnee utility customer authorize monthly deductions from a checking or savings account. To begin withdrawals the following month, the Village must receive the completed form before the 15th; it asks for utility account, contact, and bank details and requires a voided check or blank deposit slip.
Who needs it
Pawnee utility customers who want their monthly bill deducted automatically from a checking or savings account should complete this form.
How to submit it
Return the form through the outside mail slot or mail it to the Village of Pawnee, P.O. Box 560, Pawnee, IL 62558. It must arrive before the 15th to begin withdrawals the following month.
About notarization
This document is signed and dated without a notary; attach a voided check or blank deposit slip, and the signer just signs and dates the form.
How to submit this form
- 1
Download The Form
Download the Direct Debit Enrollment PDF.
- 2
Complete The Form
Print your name and address, provide utility and contact details, enter bank information, select checking or savings, then sign and date.
- 3
Gather An Attachment
Include either a voided check or a blank deposit slip.
- 4
Submit To The Village
Use the outside mail slot or mail the form to the Village of Pawnee, P.O. Box 560, Pawnee, IL 62558.
Frequently asked questions
- Do I need a notary for the Direct Debit Enrollment form?
- No. The form is signed and dated without a notary. Include a voided check or blank deposit slip with your completed form.
- How do I submit the Direct Debit Enrollment form?
- Return it through the outside mail slot or mail it to the Village of Pawnee, P.O. Box 560, Pawnee, IL 62558.
- What should I attach to the enrollment form?
- Return the form with either a voided check or a blank deposit slip.
- When must the form arrive to start withdrawals the following month?
- The Village must receive your form before the 15th of a month to begin withdrawals the following month.