What information and attachment does the form request?

It asks for customer and depository details, account and routing numbers, an effective date, and signatures. It also requests a voided check for account verification.

Do I need a notary for the Scheduled Authorization Form?

No. The form is signed and dated without a notary; it asks you to provide a voided check for account verification.

How do I submit the Scheduled Authorization Form?

The form lists the City of Fulton at 415 11th Ave, Fulton, IL 61252, but does not explain how to return it.

Fulton, IL · Whiteside County

No notary required

Scheduled Authorization Form

The Scheduled Authorization Form lets a customer authorize the City of Fulton to debit scheduled payments from a checking account and submits account details.

What this form is

This form authorizes the City of Fulton to initiate preauthorized ACH debit entries from the customer’s checking account. It is for customers setting up those payments and requests the depository and customer names, account and routing numbers, address, effective date, and signatures. The form also asks the customer to provide a voided check for account verification.

Who needs it

Customers authorizing the City of Fulton to debit preauthorized payments from a checking account need to complete this form.

How to submit it

The form lists the City of Fulton at 415 11th Ave, Fulton, IL 61252, and provides phone and fax numbers. It does not specify how to return the form.

About notarization

This form is signed and dated without a notary; the signer is asked to provide a voided check for account verification.

How to submit this form

1
Download the Form
Download the Scheduled Authorization Form PDF.
2
Complete the Form
Enter the customer and depository details, account and routing numbers, effective date, and required signatures and dates.
3
Gather the Attachment
Provide a voided check for account verification, as requested on the form.
4
Submit to the City
The form lists the City of Fulton at 415 11th Ave, Fulton, IL 61252; it does not specify how to return the form.

Frequently asked questions

What does the Scheduled Authorization Form authorize?: It authorizes the City of Fulton to initiate preauthorized ACH debit entries from the customer’s checking account.
What information and attachment does the form request?: It asks for customer and depository details, account and routing numbers, an effective date, and signatures. It also requests a voided check for account verification.
Do I need a notary for the Scheduled Authorization Form?: No. The form is signed and dated without a notary; it asks you to provide a voided check for account verification.
How do I submit the Scheduled Authorization Form?: The form lists the City of Fulton at 415 11th Ave, Fulton, IL 61252, but does not explain how to return it.

Need something notarized?

This Scheduled Authorization Form doesn’t need a notary — but Illinois residents can notarize other documents online with a commissioned online notary.