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Pre-Authorized Payment Form

 

 

If you would like to also set up your Property Tax Account for Pre-Authorized Payments, Click Here 

I/we authorize the City of Lloydminster and their financial institution to begin deductions as per my/our instructions for monthly recurring payments, for payment of all charges arising under my/our City of Lloydminster Utility Account. Regular monthly payments for the full amount of services delivered will be withdrawn from my/our specified account on the date specified below each month. The City of Lloydminster will provide a minimum of 10 days’ notice of the amount of each debit. Please debit my/our account on:
The last business day of the month effective the current month.
In the event of an overdue utility account at the time of enrollment, the initial payment will be to cover the full outstanding amount.
Terms & Conditions
1.This authorization will remain in effect until the City of Lloydminster has received written notification from me/us of its change or cancellation. The notification of change or cancellation must be received at least ten (10) business days prior to the next scheduled debit. Unless notification has been received, the PAD Agreement will renew automatically on an annual basis.
2.In the event of a property sale/account closure, it is my/our responsibility to cancel the PAD Agreementby submitting a PAD Cancellation Notice. This agreement is for the property indicated above and is not transferable to another address.
3.The City of Lloydminster will only notify the customer when a payment fails to be honored for any reason by the designated financial institution. All dishonored payments will be subject to the 1.5% penalty.
4.Any payments withdrawn from the account that are dishonored two (2) consecutive months or three (3) times in a twelve (12) month period by the applicant’s financial institution will entitle the City of Lloydminster to terminate this PAD Agreement and remove the applicant from the PAD plan without prior notice.
5.Once a utility customer has been removed from PAD for any reason, The City of Lloydminster will not reinstate the same customer on PAD for a minimum of 1 year.
6.All prior PAD Agreements between the City of Lloydminster and the Applicant are revoked upon the effective date of this Agreement.
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 a sample cancellation form, or for more information on my/our recourse rights or right to cancel a PAD Agreement, I/we may contact my/our financial institution or visit www.payments.ca.
8.I/we confirm that I/we have authority under the terms of my/our account agreement to authorize this debit.

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Your personal information is being collected under the authority of section 25 of the Local Authority Freedom of Information and Protection of Privacy Act. This information will only be used to administer the program/activity it was collected for. If you have any questions about the collection please contact the Office of the City Clerk at 780-875-6184 or email cityclerk@lloydminster.ca



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