Automated Bill Payment Authorization


If you would like to have your Scioto County Regional Water District No. 1 bill automatically deducted from your checking account each month, please complete this form and return it to our office along with a voided check.  On the date shown on your bill, Water 1 will inform your banking institution to automatically deduct the amount due for your water service.  The bank will automatically pay that amount from your designated account.  Your bank statement will itemize your payments.  You will receive a bill each month indicating the amount due and when it will be deducted from your account.  If you have questions regarding your bill, you should contact Water One immediately.  You may call or write anytime to cancel automated payments.  Water One does not charge for this service.  A separate form must be complete for each service account.


Please continue to make your monthly payments until your bill indicates that the charge is being sent to your bank.




Automated Bill Pay


I authorize Scioto County Regional Water District No. 1 to instruct my banking institution to make my Water One payments from the account listed below.  I understand that I control my payments.  If at anytime I decide to discontinue this payment service or if any of the following items change, I will notify Water One.


Your Information


Name:                                                                                              Phone:                                         


Service Address:                                                                                                                                


Service Account Number:                                                                                                                 


Authorization Signature:                                                                Date:                                           


Bank Information


Financial Institution Name:


Bank Routing Number: Account No:

(Please attach a voided check so that we can record and verify the correct banking information.)