Preauthorized Payment

_{1. For automatic payment, I/We authorize the City of Lethbridge and its Financial Institution to debit my/our account listed above, for all utilities payable to the City of Lethbridge on the Utility Billing due date as stated on the Utility Invoice.}

_{2. The authorized Debit  for Utilities may be cancelled upon written notice by me/us not less than 14 days prior to the next invoice due date.}   

_{3. I/We acknowledge any payment not honored or processed by my/our bank is subject to service charge, and that all dishonored payments made under this plan and services charges must be paid in full within 14 days of installment (due) date to continue participation in this plan, subject to the approval of Utility Services.}

_{4. In the event I/We change My/Our bank account, I will notify the City of Lethbridge not less than 30 days prior to the next due date.}

_{5. By copy of the Pre-Authorized Payment Form (PAP) being provided to applicant/owner constitutes notification of Terms and Conditions of Pre-Authorized Debit and Electronic Funds Transfer Services provided by the City of Lethbridge’ s Financial Institution.}

_{6. In the event that the City of Lethbridge wishes to terminate or amend this contract notice will be given to you.}

_{7. I/We have certain recourse rights if any debit does not comply with this agreement. For example, I/We have the right to receive reimbursement for any PAD that is not authorized or is not consistent with this PAD Agreement. To obtain a form for a Reimbursement Claim, or for more information on my/our rights, I/we may contact my/our financial institution or visit www.cdnpay.ca} 

_{The personal information requested on this form is being collected under the authority of Alberta’s Freedom of Information and Protection of Privacy Act, Section 33C, and is protected under the Act. It will be used for utility services and billing purposes and will be disclosed to a third party for the purpose of billing and/or City personnel as required. If you have any questions about the collection of this information contact Customer Care at 320-3111}