I certify that the information above is correct, that I am an authorized signer or designate of the account provided for ACH transactions, and that I am authorized to provide this information.
I authorize SW White County Water Assn. Inc. to deduct my utility payments from this bank account via Electronic Fund Transfer. I understand sending a written notification to SW White County Water Assn. Inc. will revoke this authorization. SW White County Water Assn. Inc. reserves the right to cancel Electronic
Fund Transfers due to insufficient funds without notice.