ACH Bank Draft Cancellation
  • ACH Bank Draft Cancellation

  • I hereby authorize the City of Josephine to suspend my ACH Bank Draft for my utility account. This order will remain in effect until I submit a new authorization form.

    I understand that this cancellation requires me to make my utility payments manually.

  • I understand that this form must be received at least three (3) business days prior to the scheduled draft date in order to avoid the automatic withdrawal of funds.

  • Powered by Jotform SignClear
  •  - -
  • Should be Empty: