Authorization Agreement

Fill in the below forms and click on the print button to print out the authorization agreement form. Once printed, please sign and mail or deliver the form with your voided check to: Valley Center Municipal Water District Attn: Finance PO Box 67 Valley Center, CA 92082

I/ We authorize Valley Center Municipal Water District (VCMWD) to initiate debit entries to my/our

Checking     Savings Account (select one) indicated below at the financial institution (Depository) named below, and to debit the same to such account.(Include a voided check or deposit slip with authorization)

Depository
Branch
Routing Number
Depository Acct#
Name(s)
VCMWD Acct#  

Signature               ______________________________________________
Date

check

ABA / TRANSIT
ROUTING NUMBER

 ACCOUNT
NUMBER