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Water Account Automatic Bank Payment Form

  1. Enter Bank Name

  2. As it appears on water bill.

  3. As it appears on your account.

  4. I (we) authorize the City of Waukegan and the financial institution listed above to transfer (debit) money from my (our) checking or savings account and remit payment to the City of Waukegan for my (our) water bill. I (we) further understand that it is my (our) sole responsibility to maintain sufficient available funds in my (our) account to provide for payment to the City of Waukegan on the due date. In the event that there are insufficient funds in the account and my financial institution denies payment to the City, I understand that the City will add a $35.00 service fee to my water billing account. I am authorized to transact business on the above named account. I have read and agree to the terms of t his 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 institution a reasonable opportunity to act on it.

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  6. This field is not part of the form submission.