Pre-Authorized Payment Plan Cancellation Form

Pre-Authorized Payment Plan Cancellation Form

To cancel an existing Pre-Authorized Payment Plan enrollment, please complete and submit this form a minimum of 15 days before your next pre-authorized payment date.

Roll #*

Please enter the 19 digit roll number from your tax bill.

Pre-Authorized Payment Plan Type*

Please select the type of PAP Plan that you currently have:

Monthly

Due Date

Last PAP Withdrawl*

Name*

Municipal Address*

Email Address*

Day Time Phone #*

Cell Phone #

Acknowledgements

By checking this box, I acknowledge that cancellation of a Pre-Authorized Payment Plan enrollment requires that the Town of Innisfil be notified, in writing, a minimum of 15 days prior to the due date of the next pre-authorized payment.*

By checking this box, I acknowledge that the personal information obtained through this form is collected, retained, and disclosed in accordance with the Municipal Freedom of Information and Protection of Privacy Act, R.S.0. 1990, Chapter M.56, as amended, and will be used to cancel your Pre-Authorized Payment Plan enrollment. Questions about this collection should be directed to the Finance Department, Town of Innisfil, 2101 Innisfil Beach Road, Innisfil, ON, L9S 1A1, 705-436-3710 or finance@innisfil.ca.*

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