Village of New London ACH payment fourm

Water and sewer service charges are billed monthly by the Village of New London, and are payable within 15 days. All service users have and retain the right to receive such bills and have and retain the obligation to pay them timely. However, as a convenience to our customers, the village offers the option to apply for direct payment of bills through a customers bank account. A customer retains the right to opt out of the program at any time by giving the village thirty days notice. If you are interested in participation, please complete the following authorization.

Full name*

Service Address*

City*

State*

Zip code*

Utility account number*

Phone number*

Bank name*

Account number*

Bank routing number*

I hereby authorize my bank, identified above, to pay my monthly water and sewer service charges as billed by the Village of New London through Sutton Bank (including the villages monthly service charge for this privilege) and to post these charges to my account. I understand that is my obligation to maintain an adequate balance in this bank account in order to satisfy these charges as a condition of my participation, and I understand that both I and the village retain the right to cancel my participation in this program with 30 days notice to the order. I am attaching a voided check or personalized deposit slip to evidence the account from which these payments should be made.

Date*

Full name*

Authorization for direct bank payment form

Village of New London ACH payment fourm