Delta, OH · Fulton County
Automatic Withdrawal for Water Bill
Delta water customers use this form to authorize monthly withdrawals from a checking or savings account to pay their water bill.
What this form is
This form authorizes the Village of Delta to withdraw the amount of the signer’s monthly water bill from a checking or savings account on the 21st of each month. A water customer completes it to set up automatic bill payments. It asks for the customer’s contact details, bank name and phone number, routing and account numbers, account type, and signature and date; it also includes a cancellation field.
Who needs it
Delta water customers who want the Village to withdraw their monthly water bill from a checking or savings account need this form.
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; it lists no attachment or related step that must be notarized or sworn.
How to submit this form
- 1
Download The Form
Download the Automatic Withdrawal for Water Bill form.
- 2
Complete Your Details
Enter your contact and bank account information, choose checking or savings, and fill in the cancellation field if applicable.
- 3
Sign And Date
Sign and date the authorization for monthly water bill withdrawals.
- 4
Submit To The City
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 Automatic Withdrawal for Water Bill form?
- No. The form asks for the customer’s signature and date, but does not require a notary or mention a notarized or sworn attachment.
- How do I submit the Automatic Withdrawal for Water Bill form?
- Submit it to the city department named on the form; check the city website for current contact details.
- What information does the form ask for?
- It asks for your name, address, phone number, bank name and phone number, routing and account numbers, checking or savings account type, and signature and date.
- When are automatic water bill withdrawals made?
- The authorization states that the Village of Delta will withdraw the amount of the monthly water bill on the 21st day of every month.
Need something notarized?
This Automatic Withdrawal for Water Bill doesn’t need a notary — but if you have another Delta form that does, a commissioned online notary can help.