I authorize The City of Cold Lake and the financial institution designated to begin deductions as per my instructions for monthly recurring payments for charges under my City of Cold Lake utility account. I hereby authorize The City of Cold Lake to debit my bank account as indicated on the attached void cheque included with my application.
Regular monthly payments for the full amount of services delivered will be debited to 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.
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 debit is scheduled at the address provided below.
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 notice to me at the phone number or address listed on the utility account shown on my application form. The pre-authorization will be cancelled upon three (3) payment returns. You may apply for the pre-authorization to be reinstated after 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 dishonoured payment 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.
A Pre-Authorized Payment adjustment will only be made under the following conditions:
- Authorization was not provided to the City of Cold Lake
- Payment withdrawal was not processed in accordance with the agreement.
- Authorization has been cancelled and I have chosen another method of payment.
- Any payment withdrawal dispute must be made within 90 days of the disputed debit being posted to my account.
- Any insufficient fund payments are subject to a penalty and additional fees.
I understand that I will continue to make payments on my account until the *BANK WITHDRAWAL* message appears on my bill.
