Checking Account Auto Pay Authorization Form

Please complete this form to authorize Murphys Sanitary District to set your checking account on monthly auto pay. You can choose any day of the month from the 1st - 25th for payment withdrawal. By completing this form, you authorize a one time set up fee of $.50. Processing times may vary from 3-5 days. MSD will charge a direct service fee of $35 for returned payments.

Customer # (required)

Date (required)

Service Address (required)

Email (required)

Type of Authorization (required)

Last Name (required)

First Name (required)

Mailing Address (required)

City (required)

State (required)

Zip (required)

Date of Monthly Payment (1st-25th) (required)

First Payment Amount (required)

Regular Monthly Payment Amount (required)

Please debit payments from my (required)

Routing Number: (required)

Account Number: (required)

By typing your full name below, you authorize the District to process debit transactions to your account. You also understand that this authority will remain in effect until you provide reasonable notification to terminate the authorization.

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Website Accessibility Statement

Murphys Sanitary District (the "District") is committed to ensuring that its services are accessible to all members of the public. As part of this commitment, the District strives to provide an accessible website compatible with the Web Content Accessibility Guidelines (WCAG) version 2.1, AA, and commercial screen reading software. Features of the website are created to allow individuals with vision and other impairments to understand and use the website to the same degree as someone without disabilities.

If you need any special assistance or accommodations:

Contact our compliance support team via telephone at: (888) 765-1970

Ongoing Compliance Information

Compliance Coordinator

The District has designated a Compliance Coordinator for website disability-related accommodations. The Compliance Coordinator has received training in website accessibility and updates the site in accordance with those best practices and requirements.

Compliance Procedures

The District is working to ensure all website content complies with the Americans with Disabilities Act and controlling State laws. In an ongoing effort to continually improve and remediate accessibility issues, the website is regularly scanned to ensure ongoing compliance, and timely changes are made to any inaccessible content if found.

Accessible Documents Policy

The District is committed to providing all documents hosted on the website in an accessible format or making accessible alternatives available.

Linked Documents and Third Parties

Please note that this site may link out to third-party websites that do not have accessible content. This site may also include documents provided by third parties. While we cannot control the accessibility of content provided by third parties, we are happy to assist any member of the public with reading and accessing content on our site.

Report a Website Accessibility Issue

We are committed to your ability to access all content, and we will respond to all requests in a timely manner. If you need assistance or accommodations while accessing content on this website, please contact our Compliance Coordinator via the form below:

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