ACH (Automatic Clearing House) Payment Form

Automated Clearing House (ACH) payments are electronic payments that pull funds directly from your checking account. Instead of writing out a paper check or initiating a debit or credit card transaction, the money moves automatically.

To file for and receive approval to perform ACH payments, please print and fill out the form linked below and return it to our Finance Department on the first floor of the Municipal Building at P.O. Box 660, 42 1st Street NW, Pulaski, Virginia, 24301.

ACH (Automatic Clearing House) Payment Form