Edgewood, TX · Van Zandt County
Recurring Payment Authorization Form
Edgewood Waterworks customers use this form to authorize recurring water bill payments from a checking or savings account.
What this form is
This form authorizes Edgewood Waterworks to deduct the amount shown on your water bill from your checking or savings account each billing period. It asks for your name, billing and contact information, account details, signature, and date. The authorization remains in effect until you cancel it in writing, and the form says account changes or cancellation must be reported in writing at least 15 days before the next billing date.
Who needs it
Edgewood Waterworks customers who want their water bill automatically deducted from a checking or savings account need 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 and dated without a notary; the signer just signs and dates the authorization.
How to submit this form
- 1
Download The Form
Download the Recurring Payment Authorization Form.
- 2
Complete Your Information
Provide your name, billing and contact information, and checking or savings account information.
- 3
Sign And Date
Sign and date the authorization.
- 4
Submit To The City
Submit it 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 Recurring Payment Authorization Form?
- No. The form asks you to sign and date the authorization; it does not require a notary.
- How do I submit the Recurring Payment Authorization Form?
- Submit it to the city department named on the form; check the city website for current contact details.
- What information does the form ask for?
- It asks for your name, billing address, phone number, city, state and ZIP code, email, checking or savings account information, signature, and date.
- When are recurring water bill payments deducted?
- The form says the amount indicated on your water bill is charged on the 10th or following business day of each month.