Required fields are marked with asterisks (*)

Pre-Authorized Payment Plan Enrollment Form

Applicant First Name

Applicant Last Name

Phone Number

Email Address

Select the account you would like to enroll in a payment plan

Property Tax

Water/Wastewater

Banking Information – Please upload a VOID cheque or a direct deposit form from your financial institution

Browse…

Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

By signing this form, I hereby declare:

I authorize the Township of Tay to withdraw payments from my bank account;

I am a registered property owner;

I have attached my banking information.

Applicant Signature

Clear

Notice of Collection/Use/Disclosure

Personal information contained on this form/document/application is collected pursuant to Municipal Freedom of Information and Protection of Privacy Act, and will be used for the purpose for which it was collected. Questions about this collection should be directed to the Clerk of the Township of Tay.

This authorization form will be submitted by email to taxinfo@tay.ca.

Notice of Cancellation

To cancel pre-authorized payments, please complete the online cancellation form at least 10 business days before the next withdrawal.