BANK DRAFTING ENROLLMENT FORM Customer Signature Date

ATHENS-CLARKE COUNTY
Public Utilities – Water Business Office
Bank Drafting is a service offered to all Athens-Clarke County Water Business customers. It allows your checking account to be
automatically debited each month for the amount of your water bill on the due date shown on your bill. Bank drafting eliminates check
writing, saves postage, your payments are never late and most importantly, saves your valuable time. If you are interested in the bank
drafting program, please take a moment to read and complete the form below and return it to our customer service location.
How do I initiate bank drafting?
Simply complete the form below and return it with your voided check from your current checking account to Athens-Clarke County Water
Business Office at:
124 E. Hancock Avenue
Athens, GA 30601
Fax: (706) 613-3761
When does it start?
After your authorization form has been accepted by the Water Business Office and processed by your bank, expect a thirty (30) to sixty
(60) day delay for the first withdrawal. This means the bill you receive following your enrollment in the plan will not be paid through
bank drafting. You will need to pay your bill in the normal manner that month. In subsequent months you will receive the usual water
bill that will inform you not to pay the bill because your account will automatically be drafted on the due date. You will know when and
for exactly how much your account has been drafted.
What if there is a problem with my bill?
Call us at (706) 613-3500 or stop by our office. We’ll check your account and make any necessary adjustments as well as reconcile
changes with the bank. If you have any questions our customer service representatives will be happy to assist you.
What if there isn’t enough money in my bank account?
The draft is treated as a check by your bank and the Athens-Clarke County Water Business Office. If there are insufficient funds in your
account to cover the amount of your bill on the date your account is drafted, the draft will be treated the same as a returned check and will
be subject to the same charges as a returned check.
What if I change banks or my checking information changes?
If your banking information changes you will need to complete a new form and provide a new voided check. The Water Business Office
will again have to receive authorization from your bank before the first withdrawal on your new account can be processed so you should
expect a thirty (30) to sixty (60) day delay for the first withdrawal from your new account.
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BANK DRAFTING ENROLLMENT FORM
Customer Name (Print) ______________________________________________________________________________
Home Phone: ___________________________________
Work Phone: __________________________________
Service Address: ____________________________________________________________________________________
Water Account Number: ____________________________
Bank Name: __________________________________
Checking Account Number: ____________________________ Routing Number: _______________________________
I authorize Athens-Clarke County Water Business Office to automatically draft my bank account for payment of my monthly bill. I
understand that I will be notified each month before my bank account is drafted. I also understand the bill amount will be drafted from
my bank account on the due date shown on the bill. I have the right to cancel my participation in the Bank Draft Program by notifying the
Athens-Clarke County Water Business Office in writing or in person and by giving the Athens-Clarke County water Business Office and
my banking institution a reasonable amount of time to process my request. The Athens-Clarke County Water Business Office and my
banking institution reserve the right to end my participation in the Bank Draft Program. If this occurs I will be notified in writing
following termination.
Customer Signature ___________________________________
Date __________________________
** Don’t forget to attach a Voided Check **