Water/Sewer Account Number
Name
Address
Mailing Address
Telephone: Home Work
Email
Bank/Financial Institution
Branch
Bank Account Number
I authorize the Town of Bancroft to debt my account for the amount of my current bill on the due date I agree.
Please email a copy of a VOID cheque to [email protected], or drop a VOID cheque off to the Municipal Office to COMPLETE your request.
I understand this request will not be completed with out a VOID Cheque