CITY OF ARMA
AUTHORIZATION AGREEMENT FOR DIRECT PAYMENT (ACH)
Name(s):
City Account No.
Phone: E-Mail address:
I (We) hereby authorize the City of Arma to initiate debit entries to my (our) Checking Savings account indicated below and the depository named below, hereinafter co/led DEPOSITORY, to debit same to such account.
Bank Information:
Bank Name:
City:
State:
Zip Code:
Transit/ABA No.:
Bank Account No.:
This authority is to remain in full force and effect until the City of Arma and the DEPOSITORY have
received written notification from me (us) of its termination in such time and in such manner as to afford the City of Arma and the DEPOSITORY the reasonable opportunity to act on it.
Signed: Date: _
The month the application for autodraft is completed, you will need to pay as you normally would. The following month after the information is verified with your bank, payment should automatically be withdrawn from your account. You will still receive a bill at the end of the month, with "auto draft-do not pay" printed on it.
