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Pre-Authorized Payment Plan Cancellation Form

If you require to withdraw from a pre-authorized payment plan, please submit this form a minimum of 10 business days prior to the next scheduled payment withdrawal.
Cancellation requests will be processed based on the effective date provided.
If you withdraw from a payment plan, all unpaid property tax levies and/or water bill levies become due immediately and are subject to penalties in accordance with the Municipal Act, 2001.
It is your responsibility to notify our office if you are moving and are required to cancel a payment plan. Failure to withdraw from a payment plan prior to your closing date may result in already scheduled payments to be withdrawn from your bank account. If this occurs, you will be required to reconcile any payment(s) with your lawyer.

Property Address:

Property Street Number

Property Street Name

Property Unit Number

Property Owner #1 Last Name

Property Owner #1 First Name

Property Owner #2 Last Name

Property Owner #2 First Name

Contact Phone Number

Email Adddress

Registered Property Owner Confirmation.

By checking this box, I confirm that I am a registered owner of the property for which I am requesting the cancellation of the preauthorized payment plan.

Effective Date of Cancellation

Are you cancelling your Pre-Authorized Payment Plan due to sale of property?

Yes

Paperless Billing

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

Personal Authorization

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 your request. 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 request that the Town of New Tecumseth cancel my pre-authorized payment plan, and am aware that any unpaid balances are due in full immediately and are subject to penalties in accordance with the Municipal Act, 2001.

Authorized Signature

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