Fillable CITY OF NORMAN BANK AUTHORIZATION FORM YOUR PAYMENT (City of Norman)

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CITY OF NORMAN BANK AUTHORIZATION FORM YOUR PAYMENT (City of Norman)

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OFFICE USE ONLY
CITY OF NORMAN BANK AUTHORIZATION FORM
YOUR PAYMENT WILL BE DRAFTED ON YOUR DUE DATE
__________________________________ ____________________________________
Please Print Utility Account Name Utility Account Number
________________________________________________________________________________________________
Service Address
_______________________________________________ _______________ _________________
Customer Phone Number Cycle Route
_______________________________________________ ________________ _____ _______________
Mailing Address City State Zip Code
________________________________________________________________________________________________
Name on Checking Account
Name of Bank ____________________________________________________________________________________
to charge my checking account the amount of monthly utility service bill payable to City of Norman.
P.O. Box 5599
____________________________________ ______________ Norman, OK 73070
Authorization Signature Date
N
ote: To e
nsure proper bank coding, please attach a voided blank check.
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CITY OF NORMAN BANK AUTHORIZATION FORM YOUR PAYMENT (City of Norman)

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Completed 14 July 2020

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