|
Utility Billing |
I, , authorize the City of Minot to automatically deduct my water utility bill from my bank account for the address of:
Bank:
Account Number:
Check one:
Checking
Savings
Bank Routing Number:
Signature:
____________________________________________________________________________
(Please enclose voided check blank)
For office use only: |
You will still receive your monthly water bill, but it will have the following statement on it: Direct Pmt: DO NOT PAY Your payment will be deducted from your account on the Billing Due Date. |
| Acct. Number: | |
| Cycle & Route: |
Please mail or deliver this form, with attachment,
to the Water Department Billing Office.
