Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Auto Pay Authorization

  1. (as it appears on your bill)

  2. (as it appears on your bill)

  3. (as it appears on your bill)

  4. Type of Account*

  5. Please upload a picture or scan of a VOIDED check

  6. Paperless Billing (Optional)

    I hereby authorize the City of Henderson to send my bill through my email address. I understand I will no longer receive a standard paper bill via the US Postal Service until this email option has been voided. Prompt notification of changes of my email address to the City of Henderson will be my responsibility.

  7. Auto Pay Authorization*

    I hereby authorize the City of Henderson to make automatic withdrawals from the financial institution and account specified on this authorization form. I understand that the funds will be withdrawn from my account on my normal due date. This authorization will remain in effect until cancelled by the City of Henderson or via signature by me.

  8. Leave This Blank: