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526 Country Squire Rd. Waterloo ON N2J 4G8
519-885-6840
customersupport@wnhydro.com
Pre-Authorized Payment Cancellation Form
Pre-Authorized Payment Cancellation Form
Please complete this form to authorize the cancellation of your Pre-Authorized Payment Plan.
To: Waterloo North Hydro Inc.
Name
*
I/we, cancel my/our authorization to issue Pre-Authorized debits against my/our account number(s), listed below:
First
Last
Email Address
*
Account Number(s)
*
Effective As Of:
*
MM slash DD slash YYYY
I/We acknowledge that this cancellation does not terminate any other obligation that I/We may have with Waterloo North Hydro Inc.
Signature
*
Where the Payor’s account agreement requires the signature of two or more signing authorities, the signatures of all such persons are required for the purposes of this Cancellation Notice.