Newark Valley, NY · Tioga County
Authorization Agreement for Direct Debit – Utilities
Newark Valley utility customers use this agreement to authorize quarterly direct debits from a checking or savings account for water and solid waste or recycling services.
What this form is
This agreement authorizes the Village of Newark Valley to debit a checking or savings account for water and solid waste or recycling services. It specifies quarterly payments beginning the quarter after the form date, with a choice of payment on the 10th or 25th of March, June, September, and December. The signer provides bank and account details, names, addresses, phone number, email, and signatures.
Who needs it
Village utility customers who want to pay for water and solid waste or recycling services by quarterly direct debit should complete 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 and dated without a notary; include either a voided check or a verification of account letter from your financial institution.
How to submit this form
- 1
Download The Agreement
Download the utility direct debit authorization agreement.
- 2
Complete The Form
Select checking or savings and a payment date, then provide the requested bank, account, contact, and service location details.
- 3
Gather The Required Attachment
Include either a voided check or a verification of account letter from your financial institution.
- 4
Sign And Submit
Sign and date the agreement, then 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 direct debit agreement?
- No. The form asks for signatures and a date, not notarization. Include either a voided check or a verification of account letter from your financial institution.
- How do I submit the utility direct debit 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.
- What should I include with the agreement?
- Sign and date the form, and include either a voided check or a verification of account letter from your financial institution.
- When are direct debit payments scheduled?
- The form provides a choice of the 10th or 25th of March, June, September, and December. Payments begin the quarter after the date of the form.