Utica, OH · Licking County
Authorization Agreement for Bank Drafts (ACH Debits)
Utica utility customers use this agreement to authorize bank debits and credits from a checking or savings account for a property.
What this form is
This agreement authorizes the Village of Utica to initiate ACH debit or credit entries to the selected checking or savings account for the property. It asks for bank and account details, the property address, utility account number, contact information, signatures, and dates. The document says changes or termination require 15 days’ notice and asks customers to include a voided check.
Who needs it
Utica utility customers who want to authorize bank drafts for a property complete and sign 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 completes and dates the signature lines and includes a voided check.
How to submit this form
- 1
Download the Agreement
Download the bank draft authorization agreement.
- 2
Complete the Agreement
Select checking or savings and provide the requested bank, property, utility account, and contact information.
- 3
Gather the Attachment
Include a voided check, as requested on the form.
- 4
Sign and Submit
Sign and date the agreement, then submit it to the city department named on the form.
Frequently asked questions
- Do I need a notary for the bank draft authorization agreement?
- No. The document has signature and date lines but no notary block; sign and date it, and include a voided check as requested.
- How do I submit the bank draft authorization agreement?
- Submit it to the city department named on the form; check the city website for current contact details.
- What information does the agreement ask for?
- It asks for the bank name, property address, routing and account numbers, utility account number, customer contact information, and signatures and dates.
- What should I include with the agreement?
- The form says to include a voided check. It also states that customers must give the Village of Utica 15 days’ notice for changes or termination.