Penn Yan, NY · Yates County
Direct Debit Plan Enrollment Form
Penn Yan Municipal Utilities customers use this form to authorize monthly utility bill payments by automatic bank-account debit.
What this form is
This form enrolls a customer in Penn Yan Municipal Utilities’ Direct Debit Payment Plan, which withdraws the amount due or a budget customer’s monthly budget amount on the bill’s due date. It asks for customer and service details, email-billing preference, bank and account information, and a signed authorization. Customers remain responsible for bills until they receive a bill stating direct debit is in effect.
Who needs it
Penn Yan Municipal Utilities customers who want monthly utility payments withdrawn automatically from a checking or savings account need this form.
How to submit it
Email the completed form to [email protected] or submit it in person to Penn Yan Municipal Utilities at 111 Elm Street, Penn Yan, NY 14527.
About notarization
This form is signed and dated without a notary; it asks the customer to authorize bank debits, and no notarized attachment or sworn step is stated.
How to submit this form
- 1
Download The Form
Download the Direct Debit Plan Enrollment Form.
- 2
Complete Customer Information
Enter your customer, account, phone, email, and service address details, and choose whether to receive bills by email.
- 3
Add Banking Information
Select checking or savings, enter the bank name, routing number, and account number, then sign and date the authorization.
- 4
Submit To The Utility
Email the completed form to [email protected] or submit it in person at 111 Elm Street.
Frequently asked questions
- What does the Direct Debit Plan Enrollment Form do?
- It lets Penn Yan Municipal Utilities customers authorize monthly utility bill payments by automatic withdrawal from a checking or savings account.
- Do I need a notary for the Direct Debit Plan Enrollment Form?
- No. Sign and date the form; it does not state that an attachment or related step must be notarized or sworn.
- How do I submit the Direct Debit Plan Enrollment Form?
- Email the completed form to [email protected] or submit it in person to Penn Yan Municipal Utilities at 111 Elm Street, Penn Yan, NY 14527.
- When will my utility payment be withdrawn?
- The payment is withdrawn on the due date stated on the bill. If that date falls on a weekend or holiday, the withdrawal is made the next business day.
Need something notarized?
This Direct Debit Plan Enrollment Form doesn’t need a notary — but if you have another Penn Yan form that does, a commissioned online notary can help.