Cancel Water Bill Automatic Payment

By completing this form you authorize the Village of Schaumburg to cancel the automatic payments for your water bill.

Payments are due the 20th of each month.

Requests received prior to the 16th of the month will be completed prior to the payments being due. If you are setup for auto draft, please pay your bill using an alternate method found on the back of your bill.

Requests received after the 16th of the month will be completed for the following months due date.

Questions

If you have any questions concerning this request, contact the Water Billing Division at (847) 923-4520.

Cancel Water Bill Automatic Payment

Name of Banking Institution

Type of Bank Account

Checking

Savings

Bank Account Number to Cancel

Customer Name on Water Bill Account

Water Bill Account Number

Daytime Phone Number

I have verified the information provided and agree to the terms of this request and authorization form.

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

I am authorized to transact on the bank account and water account provided.

I Agree