AUTHORIZATION AGREEMENTAuthorization Agreement for Electronic Funds Transfer • April 2nd, 2018
Contract Type FiledApril 2nd, 2018NAME SERVICE ADDRESS ACCOUNT NUMBER (as shown on utility bill) DESCRIPTION OF DEBITOKALOOSA COUNTY WATER & SEWER UTILITY BILL NAME OF BANK BANK ROUTING TRANSIT/ABA NUMBER (9 digits) BANK ACCOUNT NUMBER (include leading zeros) See check illustration on next page ACCOUNT HOLDER NAME (as shown on bank account) CHECKING ATTACH A VOIDED CHECK SAVINGS ATTACH A VOIDED DEPOSIT SLIP SIGNATURE SIGNATURE (joint account) DATE PHONE NUMBER DATE PHONE NUMBER