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Pre-Authorized Payment Cancellation Form

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Terms & Conditions

  1. 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, it is my/our responsibility to cancel the PAD agreement by submitting this PAD Cancellation Notice.
  3. A PAD Agreement that has been cancelled may be set up again but a new PAD Agreement must be submitted.
  4. I/we have certain recourse rights if any debit does not comply with the PAD Agreement. For example, I/we have the right to receive reimbursement for any PAD that is not authorized or is not consistent with the 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.cdnpay.ca.

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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