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Emailed Utility Bill & Notices

Reduce the amount of mail you receive and help the City save on postage and paper costs. Fill out the form below to receive your City of Augusta utility bill and notices by email. You also have the option to sign up for automatic bill payment directly from your bank account by filling out the information on the bottom portion of this form. You will still receive a copy of your bill, but the bill amount will automatically be deducted from your bank account on the bill’s due date. Both of these services are free of charge.

Application for Emailed Utility Bill and Notices
Full Name:
 
Address:
 
Account Number: 

Email Address: 

PIN:

Date:



Request for Automatic Bank Payment Option
Full Name: 

Account #: 

Full Address:


Bank Name: 

Bank Routing Number:

Bank Account Number:

Checking:

Savings: 


By signing below, I authorize the City of Augusta to debit the account number listed above for my utility billing. This authorization will continue to be in place until I have signed this form to cancel the authorization. I further understand that it is my responsibility to notify the City of Augusta if any of the banking information listed above has changed.

Signature: Date: 


Only fill in the portion below if you are revoking debit authorization:

I  revoke authorization for the City of Augusta to debit the
account number listed above for my utility billing.
Signature:   Date: 


     

City of Augusta Utility Office, 111 E 6th Avenue, Augusta KS 67010 or to ejones@augustagov.org. For more information or to download your own forms, visit the City’s website at www.augustagov.org or call the Utility Office at (316)775-4555.