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.

Instructions for Completion

To successfully apply, customers must complete the form in its entirety and attach an original voided check to validate their banking information.

Required Information

• Account Details: You must provide the Service Address and Account Number found on your utility invoice (top left corner under "Account Info").
• Bank Details: You must provide your bank's routing number and account number. These are located at the bottom of your checks.
• Voided Check: A voided check must be attached to the designated area on the form.

How to Locate Bank Information

The form provides a visual guide for finding the necessary numbers on a standard check:

• Routing Number: The first set of nine digits at the bottom left.
• Account Number: The second set of numbers (not to exceed 17 digits) located after the routing number.

Authorization

By signing and dating the form, the applicant authorizes Ebensburg Borough to withdraw funds from the listed account for bill payments.

Submission Details

Completed forms should be mailed or faxed to the following address:

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

Fax: 814-472-8789