Do I need a notary for the Utility ACH Payment Authorization?

No. This form is signed and dated without a notary, and it identifies no notarized or sworn attachment.

How do I submit the Utility ACH Payment Authorization?

Sign and date the form, then return it to Lehighton Borough Utility Office, PO Box 29, Lehighton, PA 18235.

When are ACH utility payments withdrawn?

The form states that payments will be withdrawn five business days before the utility bill’s due date.

What information does the ACH form request?

It asks for your name, utility account number, address, phone number, email, bank name, account and routing numbers, account type, signature, and date.

Lehighton, PA · Carbon County

No notary required

Utility ACH Payment Authorization

Lehighton Borough utility customers use this form to authorize recurring monthly utility bill payments from a bank account.

What this form is

This form authorizes Lehighton Borough to withdraw recurring utility bill payments from the customer’s bank account. It asks for utility account and contact details, bank and account information, and the customer’s signature and date. Payments are withdrawn five business days before the due date; customers may stop enrollment by completing the ACH Debit Stop Payment Request Form available in the utility billing office.

Who needs it

Lehighton Borough utility customers who want to pay recurring monthly utility bills automatically from a bank account should complete this form.

How to submit it

Return the signed form to Lehighton Borough Utility Office, PO Box 29, Lehighton, PA 18235. For questions, call the billing office at (610) 377-4004.

About notarization

This document is signed and dated without a notary; the form identifies no notarized or sworn attachment, so the signer just signs and dates it.

How to submit this form

1
Download The Form
Download the Utility ACH Payment Authorization form.
2
Complete The Form
Enter your utility account and contact details, bank information, and account type.
3
Sign And Date
Review the authorization and sign and date the form.
4
Submit To The Borough
Return the signed form to Lehighton Borough Utility Office, PO Box 29, Lehighton, PA 18235.

Frequently asked questions

Do I need a notary for the Utility ACH Payment Authorization?: No. This form is signed and dated without a notary, and it identifies no notarized or sworn attachment.
How do I submit the Utility ACH Payment Authorization?: Sign and date the form, then return it to Lehighton Borough Utility Office, PO Box 29, Lehighton, PA 18235.
When are ACH utility payments withdrawn?: The form states that payments will be withdrawn five business days before the utility bill’s due date.
What information does the ACH form request?: It asks for your name, utility account number, address, phone number, email, bank name, account and routing numbers, account type, signature, and date.

Need something notarized?

This Utility ACH Payment Authorization doesn’t need a notary — but if you have another Lehighton form that does, a commissioned online notary can help.