West Milton, OH · Miami County
Auto Pay Authorization Form
West Milton utility customers use this form to authorize monthly utility bill payments from a checking account.
What this form is
This form authorizes the Municipality of West Milton to debit a utility account balance from a checking account monthly, around the 10th. It asks for utility account, customer, service address, phone, and bank details, plus a signature and date. Attach a voided check or bank form; the first payment occurs after bank account information is validated.
Who needs it
West Milton utility customers who want monthly payments debited from a checking account should complete and sign this authorization 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 form is signed and dated without a notary; attach a voided check or bank form, which the document does not say must be notarized.
How to submit this form
- 1
Download The Form
Download the Auto Pay Authorization Form.
- 2
Complete The Form
Enter your utility account, customer, service address, phone, and bank information.
- 3
Gather The Attachment
Attach a voided check or bank form, as required by the form.
- 4
Sign And Submit
Sign and date the form, then submit it to the city department named on the form.
Frequently asked questions
- Do I need a notary for the Auto Pay Authorization Form?
- No. Sign and date the form without a notary. Attach a voided check or bank form; the document does not say that attachment must be notarized.
- How do I submit the Auto Pay Authorization Form?
- Submit it to the city department named on the form; check the city website for current contact details.
- What do I need to attach to the form?
- The form says a voided check or bank form must be attached. It also asks for your utility account, customer, service address, phone, and checking account information.
Need something notarized?
This Auto Pay Authorization Form doesn’t need a notary — but if you have another West Milton form that does, a commissioned online notary can help.