Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Public Services - Authorization Agreement For Automatic Drafts

  1. Kill Devil Hills North Carolina Birthplace of Aviation
  2. Public Services Department 

    Authorization Agreement For Automatic Drafts

    Yes, I want the convenience of having my utility bill automatically drafted from my checking account. 

  3. By electronically signing below, I authorize funds to be withdrawn from the checking account provided above. This authorization is to remain effective until the Town of Kill Devil Hills has received notification from me (account holder) requesting termination of draft. I will provide this information in such time and manner for the Town to reasonably act upon it.

  4. Please Note: Application must be accompanied by a voided check (no deposit slips) from the account to be drafted. Application must be received in office at least ten days prior to due date in order to draft current bill.

  5. Leave This Blank:

  6. This field is not part of the form submission.