Sewer Customer Auto-Pay Form

Sewer Customers — If you’d like to have your monthly sewer bill deducted from your bank account, please use the below ACH (Auto-Pay) form. Please fill it out and send it back via email to Jennifer Ransbottom (, fax 574-294-3717, or mail to the address below.

Sewer Customer Auto-pay Form (PDF Document)

Send form and voided check to:

Lakeland Regional Sewer District
PO Box 2907
Elkhart, IN 46515

Please note that you will continue to get statements showing that you owe, but those are for your records and so you know how much will be deducted on the 25th of the month. And, there is a $0.20 transaction charge that will reflect on your bank statement, but not on your sewer bill; this is a convenience charge.

If you have any questions, please do not hesitate to contact Jennifer Ransbottom at JPR, our billing agent, at 574.293-7762

Sewer Customer Auto-pay Form (PDF Document)