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2. 
3. Water Department
   City of Taylor 23555 Goddard Taylor, MI 48180
7. First Name*
8. Last Name*
10. Address*
12. City*
13. State*
14. Zip Code*
16. Email Address*
18. Phone Number*
19. Water Account Numbers to Enroll*
21. Water Account Address*
23. Name of Financial Institution*
24. ABA Routing Number*
    This is a 9 digit number on the bottom of each check.
25. Checking Account Number*
    Must submit voided check or bank verification with form (see supporting documentation upload)
27. Supporting Documentation Upload *
    Attach copy of voided check or bank verification of routing number and account number.
29. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. Please review the City's website privacy policy.

    1. I agree.
31. Electronic Signature*
32. Date*
    Date
34. It may take up to two billing cycles until your Automatic Payment Plan begins. Until your regular water bill comes marked with the words " Do Not Pay - Automatically Withdrawn", please continue to pay as usual.
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36. Submit Submit and Print

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