UTILITIES - Bank Draft Authorization

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The City of Sulphur offers the Bank Draft Program for payment of City Utilities (Water, Sewer & Trash).

  • In order to participate in the program, please fill out the Authorization Agreement below.
  • The Bank Draft will take place somewhere between the 5th and the 9th of the month.
  • If you need further assistance, please call 337-527-4522 or 337-527-4523

EMAIL A COPY OF YOUR DRIVER'S LICENSE AND VOIDED CHECK TO UTILITIES@SULPHUR.ORG

*Forms may also be dropped off at the Utilities Department

DISCLAIMERS

This authority shall remain in full force and effect until the City of Sulphur and the Depository Institution have received written notification from you of its termination in such time and in such manner as to afford the City of Sulphur and the Depository Institution a reasonable opportunity to act on it, and in no event shall such termination be effective with respect to entries processed by the City of Sulphur prior to receipt of notice of termination.

You have the right to stop payment of an individual debit entry by notification to the Depository Institution a reasonable opportunity to act on it prior to charging the account.

After account has been debited, You have the right to have the amount of an erroneous debit immediately, provisionally credited to your account by the Depository Institution, provided you send written notice of such erroneous debit to the Depository Institution within 60 days following the issuance of the account statement on which said erroneous debit first appears.

* Denotes a required field

ACCOUNT INFORMATION

Select the type of account to initiate debit entries*
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I agree to the disclaimers below*

CUSTOMER INFORMATION

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SOCIAL SECURITY #*
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PHONE NUMBER*
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DATE*
 
I agree to the disclaimers below 
 

SIGNATURE

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DATE*
 

Any additional information you want to provide?