Pre-Authourized Payment Program

AUTHORIZATION FORM:NO MUNICIPAL FEE

• For the Monthly plan a copy will be sent with the monthly withdrawal amount on January and July of each year.
• In order to adhere, your accounts must be paid in full. (may have some exceptions)
• If your banking information changes, if you are moving, or if you wish to cancel, you must advise us in writing.
• A service fee will be applied for all returned items.
• Renewal is made automatically each year, unless advised otherwise.

I authorize the Township of East Hawkesbury to withdraw the amounts as required.