PRE-AUTHORIZED PAYMENT PLAN (PAP): CANCELLATION/CHANGE

Please indicate which PAP Plan you are enrolled in (select all that apply):
 
I hereby request the following change or cancellation to the Pre-Authorized Payment Plan:
 
The reason for the Change/Cancellation is:
 

Personal information contained on this form is collected under the authority of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA), and will be used for the purpose of processing this form and administering  any changes or actioning a cancellation for the Township of Adjala-Tosorontio Pre-Authorized Payment Plan. Questions about the collection of personal information should be directed to the Clerk at clerk@adjtos.ca