Port Lavaca, TX · Calhoun County
Automatic Draft Authorization Form
Port Lavaca water customers use this form to authorize automatic withdrawals from a financial institution to pay their water bills.
What this form is
This form authorizes the City of Port Lavaca to withdraw the amount due on a water bill from the customer’s financial institution. It asks for bank and account details, the service address, water account, customer contact information, and a signature and date. Include a voided check or a bank member ID card showing the account holder’s name, routing number, and account number; the form notes drafts can take up to a full month to begin.
Who needs it
A Port Lavaca water customer who wants the city to withdraw monthly water bill payments from a financial institution 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
The signer signs and dates this form without a notary and encloses a voided check or bank member ID card to verify banking information.
How to submit this form
- 1
Download The Form
Download the Automatic Draft Authorization Form PDF.
- 2
Complete The Form
Enter your bank and account details, service address, water account, and customer contact information, then sign and date the form.
- 3
Gather Banking Verification
Enclose a voided check or a bank member ID card showing your name, routing number, and account number.
- 4
Submit To The City
Submit the completed form and banking verification to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Automatic Draft Authorization Form?
- No. The form is signed and dated without a notary. Include a voided check or a bank member ID card showing your name, routing number, and account number.
- How do I submit the Automatic Draft Authorization Form?
- Submit it to the city department named on the form; check the city website for current contact details.
- What banking document should I include?
- Include a voided check or a copy of your bank member ID card from the account you want used for monthly payments. It should display your name, routing number, and account number.
- When will automatic draft payments begin?
- The form says it can take up to a full month for the draft to go into effect, so be prepared to pay your upcoming bill manually.
Need something notarized?
This Automatic Draft Authorization Form doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.