Pre-authorized Payment Application Form

The Town of Arnprior has implemented a pre-authorized payment plan option for utility billing. To sign up for this program, complete this application form and submit it along with a voided cheque to the Town of Arnprior either in-person at Town Hall (105 Elgin Street West, Arnprior, ON K7S 0A8) or by email to utility.billing@arnprior.ca. Please note that your account must be up-to-date and in good standing to register, and all property owners must sign the application form.

Should a payment be returned by the financial institution, NSF charges will be added to the property owner’s account and interest and penalty charges will apply.

Account Information

Property Owner Information

I/We hereby authorize the Corporation of the Town of Arnprior to debit my/our account as per the attached VOID cheque, for the total bi-monthly utility bill applicable to the above noted service property. Payment will be withdrawn from account on the utility billing due date (last working day of the billing month). This authorization may be cancelled at any time upon notice by me/us.

Note: For joint accounts, all property owners must sign. Should a payment be returned by the financial institution, NSF charges will be added to the Property Owner’s account (interest/penalty charges will apply).

Personal information on this form is collected under the authority of the Municipal Freedom of Information and Protection of Privacy Act, R.S.O c.M.56 as amended and will be used to document delegates names, addresses, for pre-authorized payments. Inquiries may be directed to the Town Clerk by telephone at 613-623-4231 ext. 1818 or by email at clerks@arnprior.ca.