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Customer Pre-Authorized Debit (PAD) Agreement


Owner or Tenant Information


Payment Plan Options

Financial Information

Please see the example image below for where to find your financial information on your cheque.

By submitting this form to the Municipality of Saugeen Shores, I/we authorize the Town of Saugeen Shores to debit the bank account at the above noted financial institution for the payments indicated above.

This Pre-Authorized Debit (PAD) Agreement may be revoked at any time subject to providing notice at least 10 business days before the next debit is scheduled. To obtain a sample cancellation form, or for more information on your right to cancel a PAD Agreement, contact your financial institution or visit