Stop writing checks and start saving time! With automatic withdrawal from your checking or
savings account, paying is easy, confidential, and free!
1. Complete the contact information requested below.
Name:
Service Address:
State: Zip:
Daytime Phone: Email:
2. Provide your six-digit Waterford Township DPW account number.
3. Provide the required financial information below.
To ensure the correct account number and ABA/Routing number are used, we encourage you to
contact your financial institution for assistance.
Financial Institution:
ABA/Routing #:
Checking Account #: Savings Account #:
***Please designate a specific checking OR savings account***
4. Provide your signature for authorization.
I authorize Waterford Township Water & Sewer to deduct my payment(s) from the checking or
savings account listed above. I understand that I control my payments, and if at any time I
decide to discontinue this payment service, I will notify Waterford Township Water & Sewer.
***REQUIRED*** This form cannot be processed without your signature
Signature: Date:
DIRECT PAYMENT
ENROLLMENT FORM
Return Form to:
Waterford Township Water & Sewer
5240 Civic Center Drive
Waterford, MI 48329
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