City Utility Application for ACH (Auto Pay)

I authorize BankWest Bank, on behalf of the City of Summerset Finance Department to initiate a monthly ACH automatic debit from my account for the payment of my City Utility Bill: trash service, and wastewater/sewer fee rate charges. The amount withdrawn will be the total amount due as reflected on the billing statement prepared by the City of Summerset Finance Department. The debit entry will have an effective date the 20th of the month during which the bill is due. If this day falls on a non-business day, the effective date will be the following business day. If all or any portion of the ACH Debit should be returned or dishonored by my bank for any reason, I understand that I must submit that payment along with any applicable fees and interest to the City of Summerset by check, cash, or money order. I further understand that I can revoke this authorization through my bank and the City of Summerset at any time within a 10-day notification.