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Pre-authorized Debit Plan Agreement

Please complete the details below to be enrolled in the Pre-authorized payment plan.

Please take note of the following:

  • Taxes withdrawal on the 10th of every month excluding December.
  • Utilities withdrawal on the last business day of every month
Please select the account(s) you would like to enroll in Pre-auth

Property Address

Mailing Address

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UTILITIES: I/we authorize my/our financial institution and the Township of Havelock-Belmont-Methuen to begin deductions as per my/our instructions for monthly recurring payments, for all charges arising under my/our utility account on the last business day of each month. This authority is to remain in effect until the Township has received written notification from me/us of its change or termination at least ten business days before the next debit is scheduled. By placing a signature on this agreement I/we acknowledge that I/we have read, understand, and agree to all of the terms of the pre-authorized debit plan.

TAXES: I/we authorize my/our financial institution and the Township of Havelock-Belmont to begin deductions as per my/our instructions for monthly recurring payments, for all charges arising under my/our property tax account on the 10th of each month excluding December. This authority is to remain in effect until the Township has received written notification from me/us of its change or termination at least ten business days before the next debit is scheduled. By placing a signature on this agreement I/we acknowledge that I/we have read, understand, and agree to all of the terms of the pre-authorized debit plan.
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© 2017, Address: 1 Ottawa St. East, PO Box 10, Havelock, Ontario K0L 1Z0, Toll Free 1-877-767-2795, Phone: 705-778-2308, Fax: 705-778-5248

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