Required fields are marked with asterisks (*)

Pre-Authorized Payment Plan

217 Harper Road, Perth, ON K7H 3C6

613-267-5353

Roll Number

Name

Mailing Address

City

Postal Code

Phone Number (Home)

Phone Number (Cell)

Phone Number (Work)

Email Address

Bank Name

Branch Address

Branch Number

Institution Number

Account Number

Please notify us of any banking or payment changes a week in advance of payment date.

Any payments returned by the bank will be subject to an NSF fee of $35.00

If you have any questions, please call 613-267-5353 ext. 125 or 1-800-810-0161 ext. 125 or email deputytreasurer@tayvalleytwp.ca.

Personal Information

*Personal information collected from applications is collected under the authority of the Municipal Freedom of Information and Protection of Privacy Act, and will be used for the purposes of registering for a Pre-Authorized Payment Plan. Questions about the collection of information should be directed to the Clerk at 217 Harper Road, Perth, ON, K7H 3C6 or by phone at 613-267-5353 ext. 130 or by email at clerk@tayvalleytwp.ca.

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