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2. *ACH/EFT Utility Payments directly deduct your utility bill payment automatically from your bank account each month. Your bank account is charged the full amount of your City of Anna Utility Bill monthly on the due date (or nearest business day thereafter). Please provide a voided check if drafting from a checking account or a bank identification card if drafting from a savings account. The process of setting up a bank draft will take two billing cycles to complete. The first billing cycle will be set up as a “Pre-Note” and goes through your bank as a $0.00 amount. This allows the City to verify bank account and routing numbers. The second billing cycle will go through as a “Draft” for the full amount of the water bill. When it goes through as a “Draft” you will receive your water bill with “Draft Do Not Pay” typed on the bill. I hereby authorize the City of Anna to automatically initiate debit entries to my account, at the Financial Institution named herein, for full payment of the amount due on the Utility Bills rendered to me by the City of Anna for Utility Services. I understand that I may revoke this authorization and discontinue enrollment at any time for any reason after giving written notice to the City of Anna and allowing the City of Anna a reasonable time to act upon my notification. I further understand that if the funds are not available in my account at the time the draft is processed, I will be responsible for a $25.00 non-sufficient funds fee plus the amount of the water bill.
4. Acknowledgement*

   1. I agree
5. Email Address*
7. Effective Date*
8. Water Account No.*
10. First Name*
11. Last Name*
13. Name of Financial Institution*
14. Phone Number*
16. Bank Routing No.
17. Bank Account No.
19. Provide a scan or photo copy of a VOIDED check
20. Date
    Date
22. Please print and return this form along with a copy of a VOIDED CHECK. You may email or mail.
    Email: hburnside@annatexas.gov Mail: Utility Billing, City of Anna P.O. Box 776 Anna, TX 75409
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