Required fields are marked with asterisks (*)

Pre-Authorized Water and Wastewater Payment Plan Form

Water Account Number

Property Address

Billing Name(s):

Property Address Different than Billing Address

Yes

Telephone: (Res)

Telephone: (Bus)

Please provide a clear picture of your cheque (back and front)

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

I/we authorize the Town of Aurora to debit the bank account identified above for payment of our water account.

I/we ensure that funds will be available each month to cover the withdrawal

I would like to receive an e-mail copy of my form

Yes

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