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Village of Sussex

devers@villagesussex.org

N64W23760 Main Street
Sussex, WI 53089

(262) 246-5200

Automatic Payment Plan Form for Water/Sewer Utility

The Village of Sussex offers an Automatic Payment Plan (automatic withdrawal from your checking account) for monthly utility bills.

The automatic payment plan has the following advantages:

  • Save time with fewer checks to write
  • Help meet your commitments in a convenient and timely manner
  • Save postage or gasoline
  • Avoid late charges
  • No lost or misplaced bills
  • It is easy to set up and cancel

To implement the plan, you will need to authorize  that regularly scheduled payments be made from your checking account on the specified due date of the billing.  The authority you give to charge your account will remain in effect until you provide us written notification up to 10 days before the end of the calendar month.

Simply complete and sign the enrollment form, attach a voided check and submit to the Village of Sussex.  You will continue to receive a monthly statement showing the charges to your account and the date of withdrawal.

Should you have any questions, please contact Utility Billing at (262) 246-5224.

A voided check must be submitted with this form.

Account Name

Account Address

I authorize the Sussex Utilities to instruct my financial institution to deduct my payments for the monthly bill from my account.  If at any time I decide to change this financial institution, move from this address, or wish to discontinue this payment service, I will notify Utility Billing, in writing, 10 days prior to the end of the calendar month.  I have attached an image of a voided check.

Date

Date Picker

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Voided Check Upload

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