Towanda, PA · Bradford County
Authorization Agreement for ACH Debit Payments
Towanda water and sewer customers use this form to authorize monthly bill payments by ACH debit from a checking or savings account.
What this form is
This form authorizes the Towanda Municipal Authority, doing business as Towanda Water & Sewer Systems, to debit the bank account specified for monthly water and sewer bills. It asks for account and service details, bank information, payment account type, routing details, and the customer's signature and date. Return it with a voided check or deposit slip to set up the payment plan.
Who needs it
Towanda Water & Sewer Systems customers who want monthly bills debited from a checking or savings account need to complete this form.
How to submit it
Return the completed form with a voided check or deposit slip to Towanda Water & Sewer Systems, PO Box 229, 724 Main Street, Towanda, PA 18848.
About notarization
This document is signed without a notary; the signer signs and dates the form and includes a voided check or deposit slip.
How to submit this form
- 1
Download The Form
Download the ACH debit authorization form for Towanda Water & Sewer Systems.
- 2
Complete The Form
Enter your account, service, mailing, and bank information, select checking or savings, then sign and date the form.
- 3
Gather The Attachment
Include a voided check for a checking account or a voided deposit slip for a savings account.
- 4
Return The Form
Send the form and attachment to Towanda Water & Sewer Systems, PO Box 229, 724 Main Street, Towanda, PA 18848.
Frequently asked questions
- Do I need a notary for the ACH debit authorization form?
- No. The form has a signature and date line but no notary block; include a voided check or deposit slip with the signed form.
- How do I submit the ACH debit authorization form?
- Return the completed form with a voided check or deposit slip to Towanda Water & Sewer Systems at PO Box 229, 724 Main Street, Towanda, PA 18848.
- What bank details does the form ask for?
- It asks for the name on the account, financial institution, checking or savings account details, and the bank ABA routing number and check digit.
- How do I list multiple water or sewer accounts?
- Enter multiple account numbers separated and numbered as shown on the form. It directs customers to use the reverse side for multiple accounts.
Need something notarized?
This Authorization Agreement for ACH Debit Payments doesn’t need a notary — but if you have another Towanda form that does, a commissioned online notary can help.