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Providing Great Water for Great People
About Us
History of Cleveland County Water
Board of Commissioners
Board Meetings and Minutes
Management Team
Customer Service
Developers/Contractors
Backflow Prevention/Cross Connections
Standard Details/Forms
Education
Events & Public Notices
Finance/Purchasing
Water Quality Reports
Ways to Conserve
Bank Draft Authorization Form
CLICK HERE
to download and print form to bring into the office OR complete the online form below
EmailMeForm
Water Account Information
Customer Name
*
First
Last
Physical Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Water Account Number
*
Phone Number
*
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Cell Phone Number
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Email Address
*
Bank Account Information
Account Holder's Name
First
Last
Bank Account Number
Bank Routing Number
Name of Bank
Please attach a copy of a check from the account you wish to draft from here:
*
Attach a clear copy of a check from the bank account to be drafted. Maximum file size: 10 MB.
Security Verification
*
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