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Kitchener-Wilmot Hydro Inc. 
P.O.Box 9010, 301 Victoria St. S.
Kitchener Ontario   N2G 4L2
T: 519-743-3600| F: 519-745-3631|

Pre-Authorized Debit Agreement - Auto Pay

(I/we) authorize Kitchener-Wilmot Hydro Inc. (KWHI), and the financial institution designated (or any other financial institution (I/we) may authorize at any time) to begin deductions as per my/our instructions for regular recurring payments and /or one-time payments from time to time for payments of all charges arising under my/our KWHI account(s) including all regular bills, reconciliation bills, and final bills issued upon closure of my account.  Regular payments for the full amount of services delivered will be debited to my/our specified account on the due date of each invoice.  KWHI will provide written notice of the amount of each regular debit via their normal invoicing processes.

This authority is to remain in effect until KWHI has received written notification from me/us of its change or termination.  This notification must be received at least 10 business days before the next debit is scheduled at the address provided below.  I/We may obtain a sample cancellation form, or more information on my/our right to cancel a PAD agreement at my/our financial institution or visit Payments Canada.

KWHI may not assign this authorization, whether directly or indirectly, by operation of law, change of control or otherwise, without providing at least 10 days prior written notice to me/us.

I/we have certain recourse if any debit does not comply with this agreement.  For example, I/we have the right to receive reimbursement for any PAD that is not authorized or is not consistent with this PAD Agreement.  To obtain a form for a Reimbursement Claim, or for more information on my/our recourse rights, I/we may contact my/our financial institution or visit Payments Canada.

Please note by submitting this form, you are authorizing KWHI to deposit funds directly into your bank account when a refund is issued.

Banking information.



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All information submitted will be used by Kitchener-Wilmot Hydro Inc. in support of its obligations under the Electricity Act, 1998 and the Ontario Energy Board Act, 1998, applicable Ontario Energy Board Codes and Rules, associated policies, standards and procedures and its license. This information is being collected and used for billing and auditing purposes only. All submitted information will be assigned to the appropriate confidentiality level on receipt. This information will be retained by Kitchener­ Wilmot Hydro Inc. and may be subject to review by the Minister of Finance and/or the Ontario Energy Board pursuant to the Ontario Energy Board Act, 1998.