TOWNSHIP OF NORTH HANOVER

TOWNSHIP OF NORTH HANOVER

DIRECT DEBIT (ACH) AUTOMATED CLEARING HOUSE PAYMENT

AUTHORIZATION FORM

We are please to offer you a new service – the Direct Debit Payment Plan. Now you can have

your payment deducted automatically from your checking or savings account. And, you won’t have to

change your present banking relationship to take advantage of this service.

The Direct Payment Plan will help you in several ways:

• It saves time – fewer checks to write and mail.

• Helps you pay your bills in a convenient and timely manner – even if you’re out

of town.

• Your payment is always on time.

• It saves postage – many people spend close to $100 a year on postage.

• It’s easy to sign up for, easy to cancel

• No late charges

All you need to do is:

 Mark the box before type of account to indicate whether your

payment will be deducted from your checking or savings account.

 Fill in your name, financial institution name and date.

 Attached a voided check or savings deposit ticket.

THIS AUTHORIZATION IS TO REMAIN IN FULL FORCE AND EFFECT UNTIL THE TOWNSHIP OF NORTH HANOVER HAS RECEIVED WRITTEN NOTIFICATION

FROM ME (US) OF ITS TERMINATION IN SUCH TIME AND IN SUCH MANNER AS TO AFFORD NORTH HANOVER TOWNSHIP A REASONALBE OPPORTUNITY TO

ACT ON IT. I (WE) UNDERSTAND THE PAYMENT WILL BE PROCESSED APPROXIMATELY ON THE FIRST OF THE MONTH IN WHICH TAXES BECOME DUE.

I (WE) authorize North Hanover Township to initiate debit entries to my account indicated below.

NAME_______________________________________________________________________________

MAILING ADDRESS___________________________________________________________________

This authorization is for payment of my property tax bill.

BLOCK______________________LOT__________________QUALIFICATION___________________

Type of account to debit: (check one)______________Checking_______________Savings

Financial Institution Name________________________________________________________________

Bank Account Number___________________________________________________________________

ABA ROUTING TRANSIT NUMBER______________________________________________________

Daytime Phone#____________________________Evening#_____________________________________

_________________________________ ___________________________________________

Authorized Signature Authorized Signature (Joint Account)

PLEASE MAIL COMPLETED FORM TO:

TAX COLLECTOR – 41 SCHOOLHOUSE ROAD- JACOBSTOWN, NJ 08562