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Pre-Authorized Banking Information-Change Request

By completing this form, you authorize The Town of New Tecumseth to withdraw your pre-authorized payments from the new bank account as provided on this request. We require at least 10 business days notice before the next withdrawal date to make any changes to the banking information.

Which pre-authorized payment plan(s) are you enrolled in? Check all that apply

Property Tax Monthly Plan - 10 Months (January to October) debited on the 15th of the month or next business day.

Property Tax Due Date Plan - Debited four times a year on the installment due dates.

Arrears Payment Plan - Choose this plan if you have an outstanding property tax balance where a payment plan has been put in place with the Town of New Tecumseth

Utility Due Date Plan - Funds withdrawn on the due dates indicated on the utility bill.

Property Tax Roll Number/ Utility Account Number

Municipal Address (Street #, Street Name, City and Postal Code)

Property Owner #1 (Last Name, First Name)

Property Owner #2 (Last Name, First Name)

Contact Phone Number

Email Adddress

Paperless Billing

Enroll me into paperless billing to receive future tax /utility bills and notices by email.

Name of Financial Institution

Transit Number

Financial Institution Number

Account Number

Supporting Document Upload (Void cheque or PAD from your financial institution)

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Personal Authorization

By checking this box, I confirm that I am a registered owner of the property for which i am requesting a change to the pre-authorized banking information.

By checking this box, I acknowledge that the personal information collected on this form is collected under the authority of the Municipal Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c. M.56, and the Municipal Act 2001, S.O. 2001, c. 25. The information will be used for the purposes of responding to and processing my requests for a pre-authorized payment plan. Questions about this collection should be directed to the Clerk/Director of Administration Services, Town of New Tecumseth, 24 Tupper Street West, Alliston, Ontario, L9R 1H2, Telephone: 705-435-3900, email: clerk@newtecumseth.ca

By checking this box, I acknowledge that I/We hereby authorize the Town of New Tecumseth to debit the account I have provided for payments payable to the Town of New Tecumseth as per the payment plan(s) I have selected above.

By checking this box, I acknowledge that if a payment does not clear my bank account for any reason, an administrative fee will be imposed as per the Town's Fees and Charges By-law. A second occurrence will result in the automatic disenrollment of my account from the pre-authorized payment plan. All outstanding amounts will become due immediately and will become subject to applicable penalty. It will become my responsibility to make payments for all upcoming and future levies.