Utilities Automatic Payment Cancellation

Please complete and submit the following form to cancel your automatic utilities payments.

Account Number

Owner's Last Name

Owner's First Name

Property Address

Effective Date of Cancellation

Email Address

Primary Phone Number

Signature

By checking this box and clicking submit, I confirm I am authorized to sign for this application.

Name of Person Applicant (if different from owner name)

Privacy Statement

The personal information on this form is collected under the the Protection of Privacy Act and the Access to Information Act and will be used in order to process this form. See the Town of Olds Privacy Policy for more information.

Forms

Utilities Automatic Payment Cancellation