Christiansburg, VA · Montgomery County
Direct Utility Payment Authorization Form
Christiansburg utility customers use this form to authorize automatic bank-account payments for water, sewer, and applicable solid-waste services.
What this form is
This form authorizes the Town of Christiansburg to make recurring electronic debits from a checking or savings account for utility services. Customers provide their contact, service-location, utility-account, and bank-account details, then attach a voided check or have their financial institution verify the information. The form explains the payment schedule and how the authorization may end.
Who needs it
Christiansburg utility customers who want automatic payments from a checking or savings account can complete this authorization form.
How to submit it
Return the completed form to the Town Hall Offices, attention Director of Finance/Treasurer. Include a voided check or have your financial institution verify the bank information on the form.
About notarization
This document is signed without a notary; the customer signs and dates it, and a financial institution representative may verify and sign the account information.
How to submit this form
- 1
Download the Form
Download the Direct Utility Payment Authorization Form.
- 2
Complete the Customer Details
Choose checking or savings and enter your contact information, service locations, and utility account numbers.
- 3
Add Bank Verification
Attach a voided check, not a deposit slip, or have your financial institution verify the account information.
- 4
Sign and Date
Sign and date the authorization. A financial institution representative signs and dates the verification section if used.
- 5
Return the Form
Return the completed form to the Town Hall Offices, attention Director of Finance/Treasurer.
Frequently asked questions
- Do I need a notary for the Direct Utility Payment Authorization Form?
- No. The customer signs and dates the form without a notary. A financial institution representative may verify and sign the bank-account information instead.
- How do I submit the Direct Utility Payment Authorization Form?
- Return it to the Town Hall Offices, attention Director of Finance/Treasurer. Attach a voided check or have your financial institution verify the account information.
- What information and attachments does the form require?
- Provide customer, service-location, utility-account, and bank-account details. Attach a voided check, not a deposit slip, or have your financial institution complete the verification section.
- Which utility services can this form cover?
- The authorization covers water and sewer services, as well as solid-waste services, including garbage and recycling, if applicable.
Need something notarized?
This Direct Utility Payment Authorization Form doesn’t need a notary — but if you have another Christiansburg form that does, a commissioned online notary can help.