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Water Account Pre-Authorization Payment Plan Agreement

Please Select a Plan:

Fixed Amount (monthly withdrawal on the 30th)

Fixed Amount (monthly withdrawal on the 15th)

Installment Amount (full amount of installment withdrawn on due date)

If you selected 'Fixed Amount', you may indicate the amount: $

Unless an amount is specified this amount will be calculated by the Township. Amounts specified that result in less than full payment of all water charges will be subject to 1.25% penalty/interest per month. The Pre-Authorized Payment Plan runs from December to the following November. In the year of enrollment payments are calculated so that the estimated amounts owing by the November payment. In subsequent years payments are recalculated in December based on the prior year's usage and the current water rates in the Fees & Services By-law. Notification will be mailed 10 days prior to any change in the amount being withdrawn.

Effective Date:

Roll Number:

Municipal Address of Property:

Assessed Owner's Name(s):

Telephone:

Email Address:

Financial Institution Name:

Financial Institution Mailing Address:

Please upload a scanned/photographed blank cheque marked 'void', or a pre-authorized bank withdrawal form, obtained from your bank.

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Please indicate the Transit No., Financial Institution No., and Account No., to be debited. These numbers are found on your cheques, on your online banking platform, or can be obtained from your bank representative.