Annetta, TX · Parker County
Authorization Agreement for Direct Payment (ACH Debits)
This form lets a Town of Annetta utility customer authorize automatic ACH bank drafts from an account to pay a utility bill.
What this form is
Use this agreement to authorize the Town of Annetta to make ACH bank drafts from your account for payment of your utility bill. It asks for your name, address, financial institution, account type, routing number, and account number, along with your signature and date. The form also asks you to attach a voided check; it does not accept deposit slips.
Who needs it
A Town of Annetta utility customer who wants to authorize ACH bank drafts from an account to pay a utility bill 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 authorization is signed and dated without a notary; attach a voided check, and do not use a deposit slip.
How to submit this form
- 1
Download The Form
Download the Town of Annetta Authorization Agreement for Direct Payment (ACH Debits).
- 2
Complete The Form
Enter your name, address, financial institution, account type, routing number, and account number.
- 3
Attach A Voided Check
Attach a voided check. The form says deposit slips are not accepted.
- 4
Sign And Date
Print your name, sign the authorization, and enter the date.
- 5
Submit To The Town
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 authorization form do?
- It authorizes the Town of Annetta to make ACH bank drafts from your account to pay your utility bill.
- What information and attachment does the form ask for?
- It asks for your name, address, banking details, account type, signature, and date. Attach a voided check; deposit slips are not accepted.
- Do I need a notary for the ACH authorization form?
- No. The authorization is signed and dated without a notary. Attach a voided check, not a deposit slip.
- How do I submit the ACH authorization form?
- The form does not give submission instructions. Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Authorization Agreement for Direct Payment (ACH Debits) doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.