Do I need a notary for the ACH authorization form?

No. The document has signature and date lines but no notary block; the signer just signs and dates the authorization agreement.

How do I submit the ACH authorization form?

Return the signed form to the City of Litchfield at 221 Jonesville Street, Litchfield, Michigan 49252. Include a voided check for checking or a deposit slip for savings.

What information does the ACH form ask for?

It asks for the payment purpose, name, address, utility billing or tax account number, account type, financial institution details, transit or ABA number, account number, signatures, and dates.

Can I use this form to change or stop ACH payments?

Yes. The guidelines say to submit a new authorization agreement in writing at least 30 days before a scheduled transaction to change or stop ACH payments.

Litchfield, MI · Hillsdale County

No notary required

ACH Guidelines and Authorization Form

Litchfield residents and account holders use this form to authorize automatic bank payments for city bills, such as utility or tax accounts.

What this form is

This document explains the City of Litchfield’s ACH payment option and includes an authorization agreement for automatic debits from a checking or savings account. Complete it to start payments or to change or stop an existing ACH arrangement; the form asks for your account and financial institution details and requires a signature and date. Attach a voided check for checking accounts or a deposit slip for savings accounts.

Who needs it

Litchfield bill payers who want to start, change, or stop automatic ACH payments for a city account should complete the authorization form.

How to submit it

Attach a voided check for a checking account or a deposit slip for a savings account, then return the signed form to the City of Litchfield at 221 Jonesville Street, Litchfield, Michigan 49252.

About notarization

This document is signed and dated without a notary; the signer just signs and dates the authorization agreement.

How to submit this form

1
Download The Form
Download the ACH Guidelines and Authorization Form.
2
Complete The Authorization
Enter the payment purpose, account details, financial institution information, and signer details.
3
Gather The Attachment
Attach a voided check for a checking account or a deposit slip for a savings account.
4
Sign And Submit
Sign and date the authorization, then return it to the City of Litchfield at the address listed in the guidelines.

Frequently asked questions

Do I need a notary for the ACH authorization form?: No. The document has signature and date lines but no notary block; the signer just signs and dates the authorization agreement.
How do I submit the ACH authorization form?: Return the signed form to the City of Litchfield at 221 Jonesville Street, Litchfield, Michigan 49252. Include a voided check for checking or a deposit slip for savings.
What information does the ACH form ask for?: It asks for the payment purpose, name, address, utility billing or tax account number, account type, financial institution details, transit or ABA number, account number, signatures, and dates.
Can I use this form to change or stop ACH payments?: Yes. The guidelines say to submit a new authorization agreement in writing at least 30 days before a scheduled transaction to change or stop ACH payments.

Need something notarized?

This ACH Guidelines and Authorization Form doesn’t need a notary — but Michigan residents can notarize other documents online with a commissioned online notary.