Pre-authorized Payment is a convenient way to automatically pay your bills with your credit card.

This form provides account information and is used when arranging pre-authorized payments. Simply complete this form and submit it.

Questions? Call us at 1-519-948-5854

  • Your Information

  • Please enter the name as it appears on the credit card.
  • Please provide a phone number with area code in case we need to contact you.
  • If known, please enter your account number.
  • Credit Card Information

  • 5 digit bank transit #
  • 3 digit institution #
  • Please select whether this is for personal or business use.
  • Payment Frequency

  • We offer either monthly or quarterly payment. Quarterly payments are are on the 1st of March, June, September and December. Your 1st payment may be pro-rated for the number of months in that period.
  • Terms & Agreement

  • YYYY dash MM dash DD