Enroll in Automatic Payments | Muncie Sanitary District

To enroll in automatic payments of sewage bills, you may either:

Download and print the .pdf form AUTOMATIC WITHDRAWALS FORM and return by mail to MSD – Billing, 300 N. High St, Muncie, IN 47305,

OR

2. You may complete the online form below.

Automatic Withdrawal Form

AUTHORIZATION FOR AUTOMATIC WITHDRAWALS OF SEWAGE PAYMENTS FROM CUSTOMER BANK ACCOUNT

I (we) hereby authorize the Muncie Sanitary District to initiate charge entries for sewage payments and to initiate, if necessary, deposit entries and adjustments for any charge entries in error to my (our) account at the bank or depository named below. We would like to use the following account:

Checking Account

Savings Account

This authorization is to remain in full force and effect until the Muncie Sanitary District has received written notification from me (or either of us). Such notice must be delivered at such time and in such manner as to afford the Muncie Sanitary District and my bank or depository a reasonable opportunity to act on it. I understand that the Muncie Sanitary District will continue to mail or email a sewage bill to me advising me of the amount of my sewage charge. I further understand that the date of the withdrawal will be the same as the due date listed on my sewage bill.

NAME ON SEWAGE BILL(Required)

First Last

SERVICE ADDRESS(Required)

Street

MAILING ADDRESS

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

PHONE NUMBER

SEWAGE ACCOUNT NUMBER(Required)

BANK INFORMATION(Required)

Bank Name City State / Province / Region

ROUTING NUMBER(Required)

BANK ACCOUNT NUMBER(Required)