Laurel, MT · Yellowstone County
ACH Debit Authorization
This authorization lets a Laurel utility customer arrange direct payments from a checking or savings account to the City of Laurel.
What this form is
Use this agreement to authorize the City of Laurel to debit a designated checking or savings account for direct payments. It asks for the account type, bank and branch details, routing and account numbers, contact information, printed name, signature, and date; the authorization stays in effect until the city receives written notice to end it.
Who needs it
A Laurel utility customer who wants to authorize direct payments from a checking or savings account should complete and sign this authorization.
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 authorization is signed and dated without a notary; attach a voided check if a checking account will be debited.
How to submit this form
- 1
Download The Form
Download the ACH Debit Authorization PDF.
- 2
Complete The Authorization
Select checking or savings and enter the requested bank, account, and contact details.
- 3
Gather The Attachment
Attach a voided check if a checking account will be debited.
- 4
Sign And Submit
Print your name, sign and date the authorization, then submit it to the city department named on the form.
Frequently asked questions
- What does the ACH Debit Authorization do?
- It authorizes the City of Laurel to initiate debit entries to the checking or savings account you identify for direct payments.
- What information and attachment does the form ask for?
- It asks for bank and account details, contact information, your printed name, signature, and date. Attach a voided check if a checking account will be debited.
- Do I need a notary for the ACH Debit Authorization?
- No. Sign and date the authorization without a notary; attach a voided check if a checking account will be debited.
- How do I submit the ACH Debit Authorization?
- Submit it to the city department named on the form; check the city website for current contact details.