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.
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:
Return Form to:
Waterford Township Water & Sewer
5240 Civic Center Drive
Waterford, MI 48329
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