2. Automatic Payment Enrollment

   This enrollment form authorizes the City of Kennewick to automatically deduct payment for your utility account. After your request is processed, your payment will then be automatically made on the due date noted on your utility billing. 

   You will still receive a billing statement with a balance due but you will know that your request has been processed when the words "Auto Pay" appears under the amount due. 

   Please contact Customer Service at (509) 585-4266 if you currently have a balance due to determine if you need to send payment or if this request will be processed by your due date.

4. Utility Account Number*

   10 digit utility account number.

5. Last Name*

   Last name or business name as it appears on your utility account.

7. Daytime Contact Telephone*
9. Service Location Address*
11. E-mail address *
13. Financial Institution Routing Number*
15. Checking Account Number*

    Please double check that this account number matches what is printed on your bank statement and does not include check numbers or other additional characters.

17. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
19. Electronic Signature*
Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit Submit and Print

* indicates a required field