Lake Odessa, MI · Ionia County
Authorization Agreement for Direct Payments (ACH Debits)
This form lets a Lake Odessa water or sewer account holder authorize Lakewood Wastewater Authority and the Village of Lake Odessa to debit a bank account.
What this form is
Use this agreement to authorize Lakewood Wastewater Authority and the Village of Lake Odessa to debit a checking or savings account. It asks for the depository and account details, water or sewer account number, account holder name, date, signature, and phone number. The authorization remains in effect until the company receives written notice of termination.
Who needs it
A water or sewer account holder who wants to authorize direct ACH debits 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 document is signed without a notary; the signer just signs and dates the authorization.
How to submit this form
- 1
Download the Form
Download the Authorization Agreement for Direct Payments (ACH Debits).
- 2
Complete the Form
Select checking or savings and enter the requested depository, bank account, water or sewer account, and contact information.
- 3
Sign and Date
Sign and date the authorization.
- 4
Submit the Form
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 ACH authorization form?
- No. The form has a signature and date line but no notary block; the signer just signs and dates it.
- How do I submit the ACH authorization form?
- Submit it to the city department named on the form; check the city website for current contact details.
- What information does the form ask for?
- It asks for the depository name, branch, city, state, ZIP code, routing and account numbers, account type, account holder name, water or sewer account number, date, signature, and phone.
Need something notarized?
This Authorization Agreement for Direct Payments (ACH Debits) doesn’t need a notary — but Michigan residents can notarize other documents online with a commissioned online notary.