I authorize the City of Cold Lake and the designated financial institution to begin deductions, as per my instructions, for monthly recurring payments for charges associated with my City of Cold Lake utility account. I hereby authorize The City of Cold Lake to withdraw funds from my bank account as indicated on the attached void cheque or EFT Authorization Form included with my application.
• I understand that regular monthly payments for the full amount of services delivered will be withdrawn from my account on the due date of each City of Cold Lake utility invoice. The City of Cold Lake provides written notice of the amount on each utility invoice.
• I will notify the City of Cold Lake of any changes in the account information in writing at least five (5) business days prior to the next due date of the automatic withdrawal.
• I understand that this authority is to remain in effect until the City of Cold Lake has received written notice from me of its change or termination. This notification must be received at least five (5) business days before the next withdraw is scheduled. Notification can be given via the address provided below or email to utilities@coldlake.com or the online application on the City’s website (coldlake.com/utilities).
• I understand that cancellation of this authorization does not terminate my City of Cold Lake service but only affects my method of payment. The City of Cold Lake may terminate this authorization at any time verbally or by written at the phone number, email, or address listed on the utility account or this application form. The pre-authorization will be cancelled upon three (3) payment returns. You may apply for the pre-authorization to be reinstated after twelve (12) consecutive months without penalties being levied on the account.
• I acknowledge that the City of Cold Lake may charge my account with a service charge for each payment return as it occurs and that it may also result in termination of my participation in the Pre-Authorized Payment Plan.
• I acknowledge that provision and delivery of this authorization to the City of Cold Lake constitutes delivery by me to my financial institution.
• I understand that a Pre-Authorized Payment adjustment will only be made under the following conditions:
o Authorization was not provided to the City of Cold Lake.
o Payment withdrawal was not processed in accordance with the agreement.
o Authorization has been cancelled and I have chosen another method of payment.
o Payment withdrawal dispute has been made within 90 days of the disputed withdrawal being posted to my account.
• I understand that I will continue to make payments on my account until the *BANK WITHDRAWAL* message appears on my bill.
