Applicant Full Name

Applicant Phone Number

Applicant Email Address

Lowell Utility Account #

Financial Institution Name, City, and State

Checking or Savings

Bank Transit/Routing Number

Bank Account Number

ACH Authorization Requirements

****YOUR ACCOUNT WILL BE DRAFTED BETWEEN THE 12TH AND 17TH OF EVERY MONTH****

Upload Voided Check or Bank Letter

City of Lowell to Initiate ACH Draft