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Water/Sewer Account Automatic Bank Payment Authorization Form

  1. Enter the name that is listed on the bill.

  2. Enter the address where the service is provided.

  3. Enter your water account number found on the bill. Hint: It starts with 2.

  4. Enter the name of your bank

  5. Enter the city the bank is located

  6. Enter the state the bank is located

  7. I (we) authorize the City of Waukegan and the financial institution listed above to transfer money from my (our) checking or savings account and remit payment to the City of Waukegan for my (our) water bill. I have read and agree to the terms of this application. This authorization will remain in full force and effect until the City of Waukegan has received written notification from me (us) of its termination in such manner as to allow the City and my (our) financial instituion a reasonable opportunity to act on it. I (we) further understand that it is my (our) sole responsiblity to maintain sufficent available funds in my (our) account to prvide for payment to the City of Waukegan on the due date. In the event that there are insufficent funds in the account and my financial institution denies pay payment to the City, I understand that the City will add a $35.00 service fee to my water billing account.

  8. Please return completed form and voided check/deposit slip to: The City of Waukegan, Water Billing Department, 100 N. Martin Luther King Jr. Ave Waukegan, IL 60085. For additional questions, please contact the Water Billing Department at 847-360-0535

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