Required fields are marked with asterisks (*)

Pre-Authorized Payment Plan

For your convenience, the Township of Huron-Kinloss can make pre-authorized automatic withdrawals from your bank account for tax payments.

Choose from two convenient withdrawal options; monthly or quarterly.

Monthly

payments are withdrawn on the first business day of each month
payments are based on an eleven (11) month plan and may be adjusted as required
payments begin on the first business day of the month following receipt of completed application, unless otherwise noted

Quarterly

payments are debited on due dates as billed
payments begin on the next quarterly due date following the receipt of completed application, unless otherwise noted

Please note: Supplemental tax bills are processed in your existing PAP on the due dates as issued on the bills.

Signatures: If your account requires two signatures, both signatures must be included on this form.

Cancellation Policy: Cancellation of this plan must be received in writing by the applicant or agent acting on your behalf. The written notification must be received at least ten (10) business days before the next debit is scheduled.

NSF Administration Fee: When two transactions from your account are not successfully processed by your financial institution, the Township of Huron-Kinloss may cancel this agreement, and you will be charged the current NSF administration fee as per our by-law.

Application Date

Name

Property Roll Number

How will you provide the Township with your financial information?

Upload a copy of my financial information (VOID Cheque)

Provide my branch, transit and account numbers

I prefer to bring my financial information to the Municipal Office

Would you like to sign up for monthly or quarterly payments?

Monthly - on 1st business day of the month

Quarterly - on due dates

Preferred Start Date

Pre-Authorized Debit Category

Personal

Business

Property Address

City/Town

Email Address

Phone Number

I/We hereby authorize the Township of Huron Kinloss to debit my account for payment of property taxes to the Township of Huron Kinloss. The treatment of each payment shall be the same as if I/We had personally issued a cheque authorizing payment and to debit this amount to my/our account.

I/We, have certain recourse rights if any debit does not comply with this agreement. For example, I/we have the right to receive reimbursement for any debit that is not authorized or is not consistent with this PAD Agreement. To obtain more information on your recourse rights, I/we may contact my/our financial institution or visit www.payments.ca.

Applications will not be processed until your financial information is received.

Please sign

Clear

Secondary Signature (if required)

Clear

In accordance with the Municipal Freedom of Information and Privacy Act, personal information is collected under the authority of the Municipal Act, 2001 and will only be used for the purpose of setting up a preauthorized payment plan. Questions about the collection of the personal information may be addressed to the Clerk at the Township of Huron-Kinloss, 21 Queen Street, P.O. Box 130, Ripley, ON, N0G 2R0 or (519) 395 3735