Application for Automatic Water/Sewage Bill Payment via ACH

Overview

This document is an application form for residents to set up automatic payments for their water and sewage bills through the Ebensburg Borough. The system uses ACH (Automated Clearing House) to electronically transfer funds directly from the customer's bank account.

Key Requirements

To successfully apply, customers must complete the following steps:

• Complete the Form: Fill out all sections of the application in their entirety.
• Provide Account Details: List the Service Address and Account Number found on the top left corner of your water invoice under "Account Info. "
• Provide Bank Details: List the bank's routing number and your personal account number. This information is located at the bottom of a standard check.
• Attach Proof: You must attach an original voided check to the designated area on the form to validate the bank account information.

Submission Instructions

Once the form is completed and the voided check is attached, submit it via mail or fax to:

Ebensburg Borough Attn: ACH Water Bill 300 West High Street Ebensburg, PA 15931

Fax: 814-472-8789

Authorization

By signing the form, the customer authorizes Ebensburg Borough to withdraw funds from the listed account for bill payments. A signature and date are required in Section 5 to finalize the application.