Lacey Township, MT · Ocean County
Authorization Agreement for Direct Payment (ACH Debits)
Lacey Township residents use this agreement to authorize debit entries from a checking or savings account at a financial institution.
What this form is
This agreement authorizes the Township of Lacey to initiate debit entries to the checking or savings account selected on the document. It asks for the depository institution’s name and branch, address, routing and account numbers, along with the account holder’s name, phone number, date, and signature. It also states that the authorization remains in effect until written termination notice is received.
Who needs it
A person authorizing the Township of Lacey to debit a checking or savings account completes and signs this agreement.
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 it, and the form does not identify any notarized or sworn attachment.
How to submit this form
- 1
Download The Agreement
Download the Authorization Agreement for Direct Payment (ACH Debits) PDF.
- 2
Complete The Account Details
Select checking or savings and enter the depository, routing, account, and account holder information requested.
- 3
Sign And Date
Print the account holder’s name, then provide a phone number, date, and signature.
- 4
Submit To The Township
Submit the completed agreement to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What does the ACH debit authorization agreement do?
- It authorizes the Township of Lacey to initiate debit entries to the checking or savings account identified on the agreement.
- What information does the agreement ask for?
- It asks for the account type, depository name and branch, address, routing and account numbers, and the account holder’s name, phone number, date, and signature.
- Do I need a notary for the ACH debit authorization agreement?
- No. The document is signed and dated without a notary, and it does not identify any notarized or sworn attachment.
- How do I submit the ACH debit authorization agreement?
- The document does not give submission instructions. Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Authorization Agreement for Direct Payment (ACH Debits) doesn’t need a notary — but if you have another Lacey Township form that does, a commissioned online notary can help.