Documents>ACH Debit Authorization Form

ACH Debit Authorization Form

To sign up for Auto Pay for your utility bill please complete the form below.  There is also a PDF form available, to print and return it to the Utility Billing Clerk at 160 Zoll Street, Harbor Springs, MI 49740 by mail or in person at City Hall.  Your monthly utility payment will be automatically deducted from your bank account on the 15th of every month.  You will still receive a statement in the mail, “Auto Pay Customer” will be printed in the lower left corner.  Auto Pay may be cancelled at any time.  Please contact Tina at (231) 526-0602 if you have any questions.

PDF version

ACH DEBIT AUTHORIZATION AGREEMENT

  • Banking Information

  • *This authorization is to remain in full force and effect until the City of Harbor Springs has received written notification from the Customer of its termination in such time and in such manner as to afford the City and Depository a reasonable opportunity to act on it or for a minimum period of one (1) year.