Fillable Auto Draft Sign Up Form

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Auto Draft Sign Up Form

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CITY OF EDGEWATER
FINANCE DEPARTMENT
104 North Riverside Drive
P.O. Box 100
Edgewater, Florida 32132
customerservice@cityofedgewater.org
Phone: (386) 424-2400 FAX: (386) 424-2409
AUTOMATIC FUNDS TRANSFER (AFT)
AUTHORIZATION AGREEMENT
Automatic Fund Transfer (AFT) is an easy, convenient way to make your utility payment. AFT electronically
withdraws your payment from your checking or savings account. The amount withdrawn, date and transaction
description will appear on your monthly bank statement. You will continue to receive your utility bill reflecting
the date and amount of the AFT from your account.
Automatic Fund Transfer is a free service offered by the City that will save you time and money. AFT eliminates
the need to write checks, costly late fees and mitigates any potential interruptions of service due to non-payment.
ENROLLING IS EASY…If you are a customer of the City of Edgewater and have a checking
account in the continental United States, simply complete the application below and attach a voided
check. Please do not attach deposit slips.
Auto Draft Start Date:
Name on City of Edgewater Account
Utility Account #
Daytime Phone #
Name of Financial Institution
Bank Routing Number: (attach a voided check)
I authorize the City of Edgewater to automatically charge my bank account the total balance due
on my City of Edgewater statement on the payment due date each month.
Signature (required) __________________________________ Date _____________________
**NOTE: Continue to make your monthly payments until you see the “BANK DRAFT” message on the front of
your statement indicating that EASY pay has been activated.
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Auto Draft Sign Up Form

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Completed 14 July 2020

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