What does the automatic payment authorization do?

It authorizes the Town of Bridger to debit a checking or savings account and, if needed, make credit entries or adjustments for debit errors.

What information and attachment does the form ask for?

It asks for customer contact and address details, payment date, account and financial institution information, a signature and date, and a picture of a check blank or savings deposit slip for verification.

Do I need a notary for the Authorization for Automatic Payments?

No. The form does not require notarization; the signer signs and dates the authorization.

Bridger, MT · Carbon County

No notary required

Authorization for Automatic Payments

Bridger customers use this authorization form to arrange recurring bank-account payments to the Town of Bridger on the 10th or 20th of each month.

What this form is

This form authorizes the Town of Bridger to debit a checking or savings account for automatic payments and to make credit entries or adjustments for debit errors. Customers choose a payment date and provide contact, address, and bank-account details. The form asks for a picture of a check blank or deposit slip for verification, along with the customer's signature and date.

Who needs it

Bridger customers who want to authorize automatic payments from a checking or savings account use 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 for Automatic Payments form.
2
Complete The Form
Enter your contact and address details, choose the 10th or 20th payment date, and provide your bank-account information.
3
Gather Verification
Include a picture of a checking account check blank or savings account deposit slip for verification.
4
Sign And Submit
Sign and date the authorization, then submit it to the city department named on the form.

Frequently asked questions

What does the automatic payment authorization do?: It authorizes the Town of Bridger to debit a checking or savings account and, if needed, make credit entries or adjustments for debit errors.
What information and attachment does the form ask for?: It asks for customer contact and address details, payment date, account and financial institution information, a signature and date, and a picture of a check blank or savings deposit slip for verification.
Do I need a notary for the Authorization for Automatic Payments?: No. The form does not require notarization; the signer signs and dates the authorization.
How do I submit the Authorization for Automatic Payments?: Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

This Authorization for Automatic Payments doesn’t need a notary — but if you have another Bridger form that does, a commissioned online notary can help.