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Pre-Authorized Payment Plan Agreement

In order to enroll in the Pre-Authorized Paymen Plan the following criteria must be met:

  1. All arrears must be paid in full prior to application approval
  2. Complete the below agreement
  3. Provide a void cheque (available for upload as part of this agreement)
Please select which plan you wish to participate in
 
I/We hereby authorize the Township of Laurentian Valley to debit my/our bank account for the payment of my/our realty taxes and/or utility billing in electronic form from the Banking Institution named above.
 
This authorization may be cancelled by submitting a PAP cancellation form fifteen (15) days prior to withdrawal date.
 
I/We hereby authorize the Township of Laurentian Valley to increase/decrease the amount in accordance with our Municipal By-law as amended.
 
I/We hereby will inform the Township of Laurentian Valley in writing of any changes to the account information provided above.
 

The Township of Laurentian Valley reserves the right to remove the account from the Pre-Authorized Payment Plan if payments are in default.

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The information collected on this form is being collected under the authority of Section 342 of the Municipal Act, 2001 as amended and will be used for the sole purpose of applying pre-authorized payments to the relevant account.