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Pre-Authorized Payment Plan 

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Allowed extensions pdf

  • I (we) as the account holder(s), authorize the Municipality of Leamington and the above noted financial institution to debit my (our) account, at the above indicated branch of the financial institution, under terms and conditions agreed to me (us) with the Municipality of Leamington until such time as written notice to the contrary is given by me (us) to the Municipality of Leamington.
  • The branch of the financial institution at which I (we) maintain the account is not required to verify that the payment is drawn is accordance with this authorization.
  • I (we) will notify the Municipality of Leamington in writing of any changes in the account information or termination of this authorization prior to the next due date of the pre-authorized debit. If the debit is returned for any reason, I (we) understand that the pre-authorized payment privilege will be recinded, normal installment payments will commence and any applicable penalties and NSF fees will be charged.
  • Items charged will be reimbursed subject to notification by me (us) to the branch of the financial institution and the Corporation of Leamington together with satisfactory proof within 90 days under the following conditions:
    1. I (we) never provided authorization to the Corporation to debit my (our) account.
    2. The pre-authorized debit was not drawn in respect to this authorization.
    3. At the time of the debit, my (our) authorization had been revoked.
    4. The debit was posted to the wrong account due to invalid/incorrect account information supplied by the Corporation, and I (we) were not otherwise indebted to the Corporation.

Statement - Online Form Submission:

By submitting this online form to the Municipality, the user acknowledges that the submission is deemed to be a substitute for the user’s signature on the online form and signifies that the user has read, understood and agreed to the terms and conditions of the online form and any document referenced in the online form.



Contact(s)

© 2019 The Municipality of Leamington 111 Erie Street North, Leamington, Ontario N8H 2Z9

Phone: 519-326-5761
Fax: 519-326-2481
Email: General Information

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