Authorization for Automatic Payment

  • Please fill out ALL fields and submit one time when finished. You will receive a confirmation email when you submit the form. Please allow up to two weeks to process this request. Thank you!
  • SERVICE ADDRESS

  • MAILING ADDRESS

  • 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.
 

Verification

Fountain Hills Sanitary District Logo

16941 E. Pepperwood Circle
Fountain Hills, AZ 85268
Phone: 480-837-9444
Fax: 480-837-0819
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