Rush Notary

Roaring Spring, PA · Blair County

No notary required

ACH Bank Draft Payments Sign-Up Form

Roaring Spring Municipal Authority customers use this form to authorize monthly water or sewer utility payments by electronic bank transfer.

What this form is

This form lets customers authorize Roaring Spring Municipal Authority to deduct monthly utility payments from a checking or savings account by electronic transfer. It asks for customer and contact details, account information, bank details, and an authorized signature and date. Customers can also provide an email address to receive water or sewer bills by email.

Who needs it

Customers who want Roaring Spring Municipal Authority to deduct monthly utility payments from a bank account should complete 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 without a notary; the authorized signer simply signs and dates the form.

How to submit this form

  1. 1

    Download The Form

    Download the ACH Bank Draft Payments Sign-Up Form PDF.

  2. 2

    Complete The Form

    Enter customer and financial institution information, choose checking or savings, and provide an authorized signature and date.

  3. 3

    Submit The Form

    Submit it to the city department named on the form; check the city website for current contact details.

Frequently asked questions

What does the ACH Bank Draft Payments Sign-Up Form do?
It authorizes Roaring Spring Municipal Authority to deduct monthly utility payments from the bank account provided. Customers can also provide an email address for water or sewer bill delivery.
What information does the form ask for?
The form asks for customer contact details, an account number, bank name, account holder name, routing and account numbers, account type, and an authorized signature and date.
Do I need a notary for the ACH Bank Draft Payments Sign-Up Form?
No. This document is signed without a notary; the authorized signer simply signs and dates the form.
How do I submit the ACH Bank Draft Payments Sign-Up Form?
Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

This ACH Bank Draft Payments Sign-Up Form doesn’t need a notary — but if you have another Roaring Spring form that does, a commissioned online notary can help.