Required fields are marked with asterisks (*)

Property Tax Pre-Authorized Payment Change/Cancellation Request

Please fill out the form below if you wish to setup automatic tax payments with the Township of South Stormont

Roll Number

Owner's First Name

Owner's Last Name

Owner's E-mail Address

Owner's Phone Number

Property Address

Town/Village/Hamlet

Postal Code

Is the property owner's mailing address the same as the property address above?

Yes

Do you wish to cancel your enrolment in the Pre-Authorized Payment Plan?

Yes

Do you wish to change the account that your Pre-Authorized Payment Plan payments are taken from?

Yes

Is the name on the void cheque or direct deposit form the name of the legal property owner?

Yes

Account change must be made prior to the following withdrawal date

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