City of Big Rapids Authorization for Automatic Payment - Utility Bill

Auto-Pay Enrollment – Utility Bills

This free electronic funds transfer program is a secure, reliable way to pay your utility bill from your checking or savings account. With automatic bill payment your utility bills are paid automatically and on time each month, eliminating late fees.

When you authorize auto-pay you are giving the City of Big Rapids permission to withdraw the amount of your current utility bill. Once you enroll, the City of Big Rapids Utility Department will send you an email confirming your enrollment and the billing cycle the first automatic payment will occur. An outstanding balance at the time of form submittal cannot be bank drafted. Future utility bills will be sent for your records but will be marked “Do Not Pay - Enrolled in Auto Pay”

Payments may be rejected by your financial institution because of insufficient funds, closed account, etc. If payment is not successfully processed, late fees may apply if other payment method is not initiated before due date. Please notify the City of Big Rapids immediately of a change in your banking information by resubmitting the Auto-Pay Enrollment form.

City of Big Rapids

Authorization for Automatic Payment – Utility Bill

I authorize the City of Big Rapids to deduct payment from my checking or savings account indicated on this form. Such payments shall be equal to the amount shown, and payable on the due date shown on that bill. I understand that penalties apply if the account has insufficient funds on the due date. This authorization will remain valid until the City of Big Rapids, my financial institution, or I revoke it. If I wish to discontinue participation in the auto-pay program, I shall do so by notification in writing to the City of Big Rapids, 226 N Michigan Ave, Big Rapids, MI 49307.

Please select one of the following:

Name on Utility Account

Account Number (x-xxx-xxxxxx-xx format only - please include dashes)

Property Address

Phone Number

Receive your bill via email

Financial Institution Information

Bank Name

Type of Bank Account

Routing Number (9 numbers only)

Bank Account Number

Sign Here

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.