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DPW: Automatic Payment Plan Enrollment Form

  1. taylor-button web only.jpg

  2. Water Department

    City of Taylor 23555 Goddard Taylor, MI 48180

  3. This form is print only

    Please complete this form by signing in the respective field. Once signed please deliver or mail to the Water Department at City Hall.

  4. This is a 9 digit number on the bottom of each check.

  5. Must submit voided check with form

  6. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  7. It may take up to two billing cycles until your Automatic Payment Plan begins. Until your regular water bill comes marked with the words " Do Not Pay - Automatically Withdrawn", please continue to pay as usual.

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