Utilities Pre-Authorization Debit Application

You will need to include a scanned void blank cheque with this application.

If you cannot scan your cheque, please print and fill this form.

The Pre-Authorized Utilities Payment Plan allows you to have your monthly Utilities bill automatically debited from your personal chequing or savings account on the statement due date. You are eligible for the Plan if your account is not in arrears.

You may cancel your plan at any time with written notification to the Town of Olds. Payments
dishonoured are subject to a $20.00 service charge. After two consecutive dishonored payments, your plan may be cancelled by the Town of Olds.
In the event of a change in ownership of the property, it is your responsibility to notify the Town of Olds and arrange for cancellation or transfer of your plan.
Questions? Call the Utilities Administrator at 403.556.6981.

Files must be less than 150 MB.
Allowed file types: gif jpg jpeg png pdf.

Privacy Statement

The personal information on this form is collected under the Freedom of Information and Protection of Privacy Act and will be used in order to process this form. See the Town of Olds Privacy Policy for more information.