Ontario, OH · Richland County
Water/Sewer Pre-Authorized Payment Agreement
Water and sewer account holders use this agreement to authorize recurring automatic payments from a checking or savings account.
What this form is
This agreement authorizes the City of Ontario Water/Sewer Department to debit water and sewer bill payments from the account provided. It states that payment is withdrawn on the 20th of each month, or the following day if the 20th falls on a Saturday, Sunday, or holiday. The form asks for bank and account details, the water/sewer account information, printed name, signature, and date; it also requests a voided check.
Who needs it
Water or sewer account holders who want to authorize recurring payments from a checking or savings account can complete this agreement.
How to submit it
Attach a voided check and submit the agreement to the City of Ontario Water/Sewer Department, 555 Stumbo Road, Ontario, Ohio 44906.
About notarization
This document is signed and dated without a notary; the signer attaches a voided check, and no sworn or notarized attachment is mentioned.
How to submit this form
- 1
Download The Agreement
Download the City of Ontario Water/Sewer pre-authorized payment agreement.
- 2
Complete The Account Details
Provide the bank name and address, routing and account numbers, water/sewer account details, printed name, signature, and date.
- 3
Attach A Voided Check
Include a voided check with the agreement, as the form requests.
- 4
Submit To The City
Submit the agreement and voided check to the City of Ontario Water/Sewer Department at 555 Stumbo Road.
Frequently asked questions
- What does the ACH payment authorization do?
- It authorizes the City of Ontario Water/Sewer Department to debit water and sewer bill payments from the checking or savings account listed.
- What should I attach to the form?
- Attach a voided check, as requested on the agreement.
- Do I need a notary for the ACH payment authorization?
- No. Sign and date the agreement without a notary, and attach the requested voided check.
- How do I submit the ACH payment authorization?
- Attach a voided check and submit the agreement to the City of Ontario Water/Sewer Department at 555 Stumbo Road, Ontario, Ohio 44906.