Harrells, NC · Duplin County
Authorization Agreement for Prearranged Payments (ACH Debits)
Harrells Water Corporation customers use this agreement to authorize automatic debits from a checking or savings account for payments.
What this form is
This agreement authorizes Harrells Water Corporation to initiate charges to a customer's checking or savings account. It asks for customer, account, bank, and transfer information, and includes terms for variable amounts, stopping payment, and disputing an incorrect debit. The form directs the customer to attach a voided check.
Who needs it
Customers who want Harrells Water Corporation to debit payments from a checking or savings account 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 agreement is signed and dated without a notary; attach a voided check as directed on the form.
How to submit this form
- 1
Download The Agreement
Download the Authorization Agreement for Prearranged Payments (ACH Debits) PDF.
- 2
Complete The Agreement
Enter the requested customer, account, bank, and transfer information, then sign and date the agreement.
- 3
Attach A Voided Check
Attach a voided check as directed on the form.
- 4
Submit To The City
Submit the completed agreement and attachment 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 ACH payment authorization?
- No. The agreement has a signature and date field but no notary block; attach a voided check as directed on the form.
- How do I submit the ACH payment authorization?
- Submit it to the city department named on the form; check the city website for current contact details.
- What information does the agreement request?
- It requests customer and account details, bank name and address, transit or ABA number, account number, and transfer date.