Required fields are marked with asterisks (*)

e-Billing Enrolment

Municipality of Trent Hills

e-Billing Enrolment Application/Agreement

This program provides options for tax bills and water/sewer bills to be automatically directed to an email account.

Are you registering for Tax, Water/Sewer or both? (select all that apply)

Tax

Water/Sewer

How many Property Tax accounts are you registering for e-billing? (You will need to provide the account number for each)

How many Water/Sewer accounts are you registering for e-billing? (You will need to provide the account number for each)

Name(s) on Account:

Phone Number:

E-mail Account that your bills will be sent to:

Mailing Address

Street Address:

P.O. Box (leave blank if you do not have one):

City

Postal Code (or Zip Code):

Province (or State):

Declaration

I declare I am the account holder or representative authorized to make this change.
I agree that by submitting this form I will no longer receive paper bills in the mail. All subsequent bills including any collection notices will be directed electronically to the specified email address.
I agree that I am responsible to inform the Municipality of any standard mailing address change or email address change.
I acknowledge that receipt of bills by email does not change billing cycles, due dates or my responsibility to ensure account balances are paid.
I have added the Municipality of Trent Hills to my email’s safe/contact list

By checking this box I declare that all the information above is to the best of my knowledge correct, and agree to any terms or conditions stipulated:

I agree

Notice of Collection: Personal information contained on this form is collected pursuant to the Municipal Freedom of Information and Protection of Privacy Act, and will be used for the purpose of processing the E-Billing Enrolment Application/Agreement. Enquiries regarding the collection of this information may be directed to the Office of the Clerk/Freedom of Information Coordinator, Municipality of Trent Hills, 66 Front Street South, Campbellford, ON K0L 1L0 705-653-1900