Required fields are marked with asterisks (*)

Administrative Monetary Penalty System Payment Form

Please pay special attention to the payment section on the Penalty Notice. If a payment is not made in full or is incorrect, it may not be applied to the Penalty Notice. Consequently, the Notice will be documented as unpaid and extra administrative fees may apply.

To complete your payment online you will need your Penalty Notice Number, mailing address and a credit card (Visa, Mastercard, American Express and Discovery Network accepted). Payments are processed by our third party payment provider - Worldline Bambora.

The Worldline service charge to accept credit card payments is 3% of the total invoiced amount. The service charge will be added at time of transaction.

Please complete the form in full, including the payment form on page 2, and hit submit. Payments appear on your credit card statement as "Bambora Internet PSP" from Victoria B.C.

You will receive confirmation of your payment through email. If you have a question about your payment please call 519-395-3735 or email sphelan@huronkinloss.com. If you have questions about your notice please follow the instructions on the notice or contact our By-law Enforcement Services at 519-395-3735.

Please note: All fields are required.

First Name

Last Name

Phone Number

Email Address

Mailing Address

Town

Postal Code

Penalty Amount

Penalty Notice Number

Penalty Date

Payment Date

Signature

Clear

Privacy of Information

The information supplied is for use by the Township of Huron-Kinloss and will not be sold or distributed without consent. The personal information collected will be used by the Township of Huron-Kinloss to apply a payment to a Penalty Notice. The collection and disclosure of the information is governed by Municipal Freedom of Information and Protection of Privacy Act (MFIPPA), 1990. For more information or questions about the collection of information, contact 519-395-3735.