Authorization for Automatic Payment

  • Please fill out ALL fields and submit when finished. Thank you!


  • I authorize the following institute to accept the funds transfers and charge my checking or savings account shown below to pay Fountain Hills Sanitary District sewer bills or to credit my account if it is necessary to make corrections. This authorization is in effect until I contact FHSD in writing.
  • Upload a photo of a voided check or a statement from your financial institution with the Routing and Account Numbers on it. Failure to include one could delay your enrollment.