Town of Mocksville

Authorization Agreement

ACH Preauthorization Payments (Debits)

This form authorizes the Town of Mocksville to initiate automatic payments of your utility services. Accounts will be drafted by the 12th of the month your bill is due.

You may complete this form online and upload a copy of your voided check, or if you prefer, download and print a copy here.

Visit the office or mail the completed authorization form with a copy of your voided check to:

Town of Mocksville
171 S. Clement Street
Mocksville, NC 27028

If you have questions please call 336-753-6700 or email HERE.

Authorization Agreement

  • Accepted file types: jpg, gif, png, pdf, jpeg, tiff, Max. file size: 128 MB.
    You must attach a copy of a VOIDED check.