Village of Lawton Authorization for Electronic
Submission of Monthly Sewer & Water Utility Bill
Village of Lawton is pleased to offer another method for its residents and customers to receive their monthly sewer &
water utility bill(s). By simply submitting this form, your monthly utility bill will be electronically sent via e-mail to the
address provided.
I (we) hereby authorize Village of Lawton to initiate the Electronic Submission of my (our) Monthly Sewer &
Water Bill to the e-mail address provided on this form. I (we) understand that it is my (our) responsibility to
provide the Village with a valid and current e-mail address in order to receive this service. I (we) further
understand that I (we) will no longer receive utility bills via U.S. mail while signed up for this service and
payment due dates must still be observed to avoid late fees. Monthly utility bills are sent on or near the 8
th
of
every month. This authorization can be terminated at any time by submitting written notification to the Village.
Please check one:
YES – I (we) would like to participate in the Electronic Submission of my (our) Monthly Sewer & Water Utility
Bill. I (we) understand that the quarterly sewer & water bill will be electronically sent via e-mail to the address
provided on this form.
CHANGE – Please change the e-mail address for where my (our) monthly sewer & water bill is electronically
sent. I (we) have listed the new address below.
STOP – Please stop my (our) participation in the Electronic Submission of Monthly Sewer & Water Utility Bills
(when this service is stopped, you will automatically go back to receiving bills via U.S. mail).
Name(s) on Account ______________________________________________________________
Billing Address
______________________________________________________________
Utility Billing Account Number
_________________________________________________
Phone Number(s)
______________________________________________________________
E-mail Address
______________________________________________________________
/
Signature(s) Date
/ /
Submit form to: Village of Lawton, 125 S Main St., P.O.Box 367 Lawton, MI 49065 or to leonardm@lawtonmi.gov
Completed form(s) must be received by the 1
st
of the billing month in order to send the utility bill electronically.
If received after this due date, it will become effective the following month.
