Application for Pre-Authorized Banking Information Change

This application is used to notify the City of Kitchener that I wish to change my financial institution information for pre-authorized payments for property taxes and/or utilities.

Applicant and financial information

Payor

Application form must be submitted by the Payor

   

Property (or service) address

Mailing address

Financial institution

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Cheque example showing cheque number, transit number, institution number and account number

By entering this agreement you certify that you are authorized to enter this agreement with respect to the financial institution account information provided without consent from any other persons or entities. If more than one signature is required on cheques issued against the account, this agreement may not be entered into online and a signed agreement must instead be submitted with all required signatures. The agreement can be downloaded from the City of Kitchener’s website.