Auto Draft Enrollment

When enrolled in Auto Draft, you authorize us to automatically draft the Total Amount Due from your designated bank account each month on the due date, or the last business day prior to the due date.
There are no fees for Auto Draft and you will continue to receive your monthly bill.
Please allow one billing cycle for Auto Draft to begin.
You can discontinue Auto Draft at any time by completing the Cancel Auto Draft form.

Name*
First Last
Phone
Email*
Alabaster Water Account Number*
Service Address*
Street Address City State ZIP Code
Bank Name*
**Please ensure the Routing Number and Bank Account Number match what is printed on the check or what is provided by the banking institution. Incorrect or fraudulent information will result in the payment being returned.
Routing and Transit Number*
Checking Account Number*
Terms*
- I Agree to the Terms and Conditions of Auto Pay
  AUTO PAY TERMS AND CONDITIONS AUTHORIZATION AGREEMENT FOR ELECTRONIC FUNDS TRANSFER (DEBITS)
  I hereby authorize Alabaster Water Board (Board), as my agent, to automatically debit my bank account for payment of all bills associated with requested accounts. The Board will advise, by notice on my bill, of the date my bank account will be debited. I understand I must notify the Board promptly upon receipt of my bill of any dispute regarding the amount of the bill.
  I understand the Board may impose a returned check fee if the draft is not paid by my bank. I authorize the Board to update my bank account information upon notification from my financial institution. Upon customer request, this authorization will remain in effect if my Board account number or service address changes or if I add additional account numbers. This authorization will be in effect until either party gives notice to the other of termination. I understand my notice must be received by the Board in time for it to have a reasonable opportunity to act.
  IN CONSIDERATION OF THIS SERVICE, TO THE EXTENT PERMITTED BY APPLICABLE BY LAW, I AGREE THAT THE BOARD WILL NOT BE RESPONSIBLE FOR CLAIMS RELATING TO THE DEBIT OF MY ACCOUNT. UNDER NO CIRCUMSTANCES WILL THE BOARD BE LIABLE FOR CONSEQUENTIAL OR SPECIAL DAMAGES. THE BOARD WILL NOT BE LIABLE FOR THE ACTS OR OMMISSIONS OF OTHERS, INCLUDING THE BANK AND CLEARING HOUSES WHICH RECEIVE AND TRANSMIT THE DEBIT INSTRUCTIONS.
By submitting the information above, you agree to the Terms and Conditions. Typing your name below will serve as your electronic signature.*