Direct Pay Form

We are pleased to be able to offer you a Direct Payment Plan Option. Now you can have your water payments automatically deducted from your checking or savings account. You do not have to change your present banking relationship to take advantage of this service. Please fill out the form below to get started.

Here’s how it works: 
You authorize your City of Newberg utility bill to be paid directly from your checking or savings account.  For your records, a utility statement showing usage and amount billed will be mailed to you and the payment will be debited from your account on the date selected below. The authority you give to charge your account will remain in effect until you notify us in writing to terminate the authorization. The cancellation request must be 3 working days before the date selected below. 

The Direct Payment Plan is dependable, flexible, convenient and easy. To take advantage of this service, complete the attached authorization form and return it to us at 401 E Third Street, or mail to PO Box 970 Newberg, OR 97132. If you have any questions about the Direct Payment Plan, please call the Finance Department at (503) 537-1205.

Edit Form

I authorize the City of Newberg and the financial institution named below to initiate entries to my account. This authority will remain in effect until I notify the City of Newberg in writing to cancel it in such time as to afford the financial institution a reasonable opportunity to act on it. I can stop payment of any entry by notifying the City of Newberg three (3) days before my account is charged. This authority will remain in effect until it has been cancelled in writing.*

Yes

No

Payment Option - Choose One*

Checking Account

Savings Account

Payment Date - Choose one*

15th of the month

30th of the month

Name*?

Email Address*

Date of Submission*?

Service Address*

City, State, ZIP*

Mailing address (if different from service address)

City, State, ZIP

Financial Institution*

Account Number at Financial Institution*

Confirm Account Number*

Routing Number at Financial Institution*

Confirm Routing Number*

City of Newberg Utility Billing Account Number - Do not include hyphens*

Confirm Utility Billing Account Number - Do not include hyphens*

Digital Signature*?