Customer Service - Auto Pay Form

Auto Pay Form

We can help you manage this electronically with our Auto Pay Form. Your bank account is debited monthly for your payment. "Go Green" - sign up now.  Please note, the Auto Pay Form requires an original signature received in our office.

Download the Auto Pay Form.
Note:  This requires Adobe Reader to view/Print.

After you have completed the form, please mail it to:

Dowser Water
Attn:  Accounts Receivable
One Pepsi Way
Newburgh, NY 12550