Direct Bank Draft - Greeneville Water Commission

Fill out the Direct Bank Draft form below. You can also print and either email it or bring it to our office. Please include a voided check.

NOTE: You will receive a bill as normal, but your payment will be automatically deducted from your account within two (2) days of the due date.

SIGNING UP IS EASY!
The GREENEVILLE WATER COMMISSION, Company ID NUMBER 626000299.
I (We) hereby authorize The GREENEVILLE WATER COMMISSION, Hereinafter called Company, to initiate debit entries to my account indicated below at the depository financial institution named below, hereafter called DEPOSITORY, and to debit the same to such account. I (We) acknowledge that the origination of ACH transactions to my (our) account must comply with the provision of U.S. law. Transaction will take place at the bank two (2) working days prior to the normal penalty or due dates, debit will be for the amount on the monthly statement
Please debit my*
- Checking Account
- Savings Account
Depository Name*
Branch
Bank Address
City State ZIP Code
Bank Routing #*
Bank Account #*
The Authorization is to remain in full force and effect until COMPANY has written notification from me (or either of us) of its termination in such time and in such manner as to avoid COMPANY and DEPOSITORY a reasonable opportunity to act on it.
Name(s)*
Address*
Street Address City State ZIP Code
Date*
MM slash DD slash YYYY
Signature*
Greeneville Water Commission Account #*
NOTE: All debits authorizations MUST provide that the receiver may revoke the authorization only by the originator in the manner specified in the authorization. Depository must maintain adequate balance or ACH privileges will be revoked by the COMPANY. The Greeneville Water Commission