Pre-Authorized Payment Application Request Form

Using the form below, select the plan you wish to enroll in, and Taxation Services will prepare the application form within one to two business days. The prepared application form will be sent to the email address provided using Adobe Sign. You will not be able to forward the application form to another email address.

This form does not automatically enroll you for pre-authorized payments.

As part of the application process, we will collect bank account information, which must be registered under the name of the individual signing the application.

Pick your plan

Please select one of the following pre-authorized payment plans:

• Monthly— Payments are withdrawn monthly on the first of each month from December to November.
• Instalment— The instalment amount is withdrawn from your account on the instalment due dates shown on your tax bill.  

The personal information recorded on this form is collected and maintained in accordance with the Municipal Freedom of Information and Protection of Privacy Act and will be used for the sole purpose of processing your request.

Questions about the collection of this data can be directed to:

Municipality of Clarington
Legislative Services Department
clerks@clarington.net 
905-623-3379