Auto Pay- Utility Bill Direct Payment

Please complete this Autopay form (aka direct debit) if you'd like to pay your Village water/sewer utility bill via automatic withdrawal from your checking or savings account. Users of this payment method will enjoy the convenience of having the balance due on their Village utility account paid automatically each month.

In addition to being convenient, payment of water bills through Autopay reaps the following benefits for customers:

NO fees charged for this service.
NO need to worry about lost utility bill.
NO need to write a check each month.
NO late fees as bills are always paid on time.
NO fear of disconnection for overlooked payment.
STILL receive a copy of bill with usage and amount due indicated that will be debited from bank account each month.

Please refer to this example when completing the form below. If you have questions related to the Autopay program, please feel free to call 815-207-4631.

First & Last Name (as shown on bill)Address:City:State:ZIP:Phone #:Email:Utility Billing Account Number (EX: 123456-789)Bank Name:Bank Account Type:

Checking

Savings

Bank Routing Number (9 digits on bottom left of check):Bank Account Number:

I (we) hereby authorize the Village of Shorewood, to initiate debit entries to my (our) checking account indicated below and the financial institution named above, hereinafter called FINANCIAL INSTITUTION, to debit the same to such account. I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of U.S. Law. You should continue to pay your bill until you receive your first bill which indicates that you are on the direct payment program.

By answering yes and submitting this request form, I agree, I have read and understand the above paragraph.

Yes

Auto Pay- Utility Bill Direct Payment

Form is currently unavailable for maintenance. Please call the Village Hall at 815-725-2150