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Automatic Payment Application

Instructions on filling out this form

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Donec malesuada semper dapibus. Nulla id tortor varius, pretium augue ac, accumsan odio. Nullam nec mollis nisl. Praesent sed imperdiet arcu. Mauris adipiscing, enim sed eleifend accumsan, diam eros porta nisl, nec mollis lectus mi sit amet elit. Fusce tincidunt ipsum quis sem egestas scelerisque. Nulla porttitor eros in est feugiat sagittis. Duis a nisl imperdiet, condimentum lacus tempus, pretium mauris. Suspendisse a nisi dictum, sagittis leo eget, sagittis dolor.

Complete this application for automatic payment and upload a voided check for review.

Account Basics:

Today's date

December 15, 2025

Bank Information:

Name of Bank

Branch

Phone

City

State

Zip

Name(s) on Account

Transit/ABA/Routing #

RETYPE Transit/ABA/Routing #

Bank Account #

RETYPE Bank Account #

Customer Information:

Account Number

Name on Account

First Name

Last Name

Street Address

City

State

Zip Code

Email Address

Phone Number

Terms

I AUTHORIZE Skyway Water & Sewer District to initiate deductions, and the financial institution listed below, to transfer payment, for and in the full amount of my utility bill. This authorization will remain in effect until cancelled. I understand I may discontinue at anytime by giving written notice to Skyway Water & Sewer District.

Automatic payment may be cancelled by Skyway Water & Sewer District upon notification from the bank of non-sufficient funds or closed accounts, which would result in a $35.00 service charge added to the account.

Please type your initials to indicate you have read and understood the above terms.

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Contact Us

Skyway Water & Sewer District
6723 S 124th St.
Seattle, WA 98178
206-772-7343 Office
207-842-4719 After Hours
206-772-5860 Fax
Contact via E-mail