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Auto Pay Form

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Dear Valued Customer,

Oro Valley Water Utility would like to take this opportunity to invite you to sign up for our Automated Bill Payment (ACH) program. This service offers you an easy and convenient way to pay your water and sewer bill each month without the hassle of remembering to write a check. Your water bill is paid automatically each month from your checking or savings account. To enroll in the ACH program, simply complete the application below and return it along with a VOIDED check to the Oro Valley Water Utility.

Eliminate long mail delays. Avoid late fees. Have a carefree extended vacation.

With our ACH program, you will save time and money. No checks to write, no postage to pay, no need to forward your mail or arrange for someone to pay your bill while you are away from home.

You will continue to receive a monthly statement for your records. The statement will include the amount and date that the payment will be deducted from your account and will say “Do Not Pay” to remind you that you no longer need to send in a check. Your water and sewer bill will be electronically deducted directly from your checking or savings account every month on the due date. If you have more than one account with Oro Valley Water Utility, sign them all up for ACH to begin hassle-free bill paying!

If you are interested in ACH, please fill out the form at the bottom of this page, sign and date the authorization, attach a voided check and we will enroll you in the ACH program. This application takes approximately one complete billing cycle (1 month) to implement. Mail your application to:

Oro Valley Water Utility
11000 N. La Canada Drive
Oro Valley, AZ 85737
------------------------------------------------------------------- (cut here to detach application)

 

Oro Valley Water Utility
Automated Bill Payment Application and Agreement

 

Name (as shown on your water bill) _______________________________________________________________

 

Oro Valley Water Utility Account Number _________________________________________________________

 

Service Address________________________________________________________________________________

 

City ________________________________ State ____________________________ Zip ____________________

 

Name (as shown on checking account) ______________________________________________________________

 

Checking/Saving Account Number _________________________Routing Number _________________________

(circle one)

Financial Institution __________________________________ Phone Number _____________________________

 

Address _______________________________ City __________________ State _______________ Zip _________

 

I hereby authorize Oro Valley Water Utility and the Financial Institution above to charge the account I have specified for payment of my water bill. I understand that a fee will be charged to my account for each request returned for insufficient funds. In addition I understand that both the financial institution and the Town of Oro Valley reserve the right to terminate this payment plan and/or my participation. Should I choose to withdraw from the plan, I will notify the Oro Valley Water Utility in writing, 30 days in advance.  ACH will be terminated upon closing of account.

 

Signature _________________________________________________________

Date Signed ____________________________

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