Required fields are marked with asterisks (*)

Water - Pre-Authorized Banking Information Change Request

By completing this form, you authorize The Town of Whitchurch-Stouffville to withdraw your pre-authorized payments from the new bank account as provided on this request.  This change will not occur until the effective date noted on the submission.

Please enter your 'Void Cheque' information below. Line of Credit Cheques not accepted.


  Void Cheque Example


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

I/We authorize the Town of Whitchurch-Stouffville to change our banking information on the effective date and begin deductions for payment of my/our water account. I/We ensure that the funds will be available to cover the withdrawal. Insufficient funds will result in service charges as applicable and possible cancellation of my/our enrollment in the payment plan. This authority will remain in effect until cancelled by either myself or the Town of Whitchurch-Stouffville with at least fourteen (14) days written notice.

I/We have certain recourse rights if any debit does not comply with this agreement. For example, I/We have the right to receive reimbursement for any debit that is not authorized or is not consistent with the PAD agreement. To obtain more information on my/our recourse rights, I/we may contact my/our financial institution or visit

I/We have agreed to the above statement

Personal information contained in this form is collected under the authority of Municipal Act, 2001 and will be used for the purpose of updating your account information. Questions about this collection should be directed to Manager Revenue and Taxation, Town of Whitchurch Stouffville, 111 Sandiford Drive, Stouffville ON L4A 0Z8, Telephone: (905)640-1900, email: 

Scroll to top