Wytheville, VA · Wythe County
Bank Draft Authorization Form
Wytheville water and sewer customers use this form to authorize monthly bill drafts from a checking or savings account.
What this form is
This form authorizes the Town of Wytheville Treasurer’s Office to draft monthly water and/or sewer bills from the financial institution and account listed. The customer provides contact details, account number, bank transit number, and bank account number, selects checking or savings, and signs and dates the authorization. A void check or void deposit/withdrawal slip is requested, depending on the account type.
Who needs it
Wytheville water and/or sewer customers who want their monthly bill drafted from a checking or savings account should complete this form.
How to submit it
Print the form and send it to Town of Wytheville Billing Department, PO Box 533, Wytheville, VA 24382.
About notarization
This document is signed without a notary; attach a void check for checking or a void deposit/withdrawal slip for savings, then sign and date the authorization.
How to submit this form
- 1
Download the Form
Download and print the Bank Draft Authorization Form.
- 2
Complete the Form
Provide your contact, water and/or sewer account, and bank account details; select checking or savings and sign and date.
- 3
Gather the Attachment
Attach a void check for a checking account or a void deposit/withdrawal slip for a savings account.
- 4
Send the Form
Mail it to Town of Wytheville Billing Department, PO Box 533, Wytheville, VA 24382.
Frequently asked questions
- Do I need a notary for the Bank Draft Authorization Form?
- No. The form has no notary block; sign and date it. Attach a void check for checking or a void deposit/withdrawal slip for savings.
- How do I submit the Bank Draft Authorization Form?
- Print the completed form and send it to Town of Wytheville Billing Department, PO Box 533, Wytheville, VA 24382.
- What information does the form ask for?
- It asks for your name, street address, telephone number, water and/or sewer account number, bank name, bank transit number, and bank account number.
- What attachment do I need for my account type?
- For checking, attach a void check. For savings, attach a void deposit/withdrawal slip.