Remove Pre-Authorized Payments Plan Form

Customer Request - Remove Pre-Authorized Payments Form

Remove Pre-Authorized Payments Form
Please complete and submit the form below to remove pre-authorized payments from your account.

*** In order to allow sufficient time for processing, we require that this form is submitted at least five (5) business days in advance of your next automatic withdrawal date. ***
Welland Hydro Account Number * Required
Account Holder - Full Name * Required
Account Holder - Email Address * Required
Account Holder - Phone Number * Required
Service Address * Required
Street Address Address Line 2 City Province Postal Code
Removal from Pre-Authorized Payments - Effective Date - must be mm/dd/yyyy format * Required
MM slash DD slash YYYY

Specify the date you would like pre-authorized payments to be removed from your account. In order to allow sufficient time for processing, Welland Hydro requires at least five business days notice prior to your next withdrawal date.
Confirmation * Required
- I confirm that I am the account holder and that the information provided is complete and accurate. I understand that by removing pre-authorized payments from my account, monthly payments will no longer be automatically deducted from my bank account. Moving forward, it will be my responsibility to make manual payments on a monthly basis.
  
  I am also aware Welland Hydro recommends requests for removal be sent five business days in advance of the next withdrawal date to allow sufficient time for processing. In the event a submission is received less than five business days before the next withdrawal date, Welland Hydro is not responsible for any payment return / NSF fees incurred.
Collection of Personal Information
NOTICE OF COLLECTION: Your personal information is collected on this form by Welland Hydro-Electric System Corp. (“Welland Hydro”) under the authority of the Electricity Act, S.O. 1998, Chapter 15, Schedule A. Welland Hydro will only use personal information for the purpose for which it was collected unless consent is given by the individual to use or disclose it for another purpose. Under certain exceptional circumstances, Welland Hydro may have a legal duty or right to disclose personal information without the individual's knowledge or consent. If you have further questions about this collection, or the ways in which your personal information may be used by Welland Hydro, please contact the Privacy Officer by telephone at 905-732-1381, ext. 233, or by email at privacy@wellandhydro.com.
Submit My Remove Pre-Authorized Payments Form
By selecting the "Submit My Remove Pre-Authorized Payments Form" button below, the request will be sent for processing.
CAPTCHA

Customer Request - Remove Pre-Authorized Payments Form

Remove Pre-Authorized Payments Form

Collection of Personal Information

Submit My Remove Pre-Authorized Payments Form