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eBilling Consent Form

Property owners and water account holders in the Municipality of Brighton

Consent:

I agree that by submitting this form I will no longer receive paper documents via Canada Post. All correspondence will be electronically sent to the specified email address. It is the responsibility of the customer to inform the Municipality of any email address changes.

Applicant Name:

Email address:

Account Information

To assist with account verification, please provide the following information.

Please select the bill(s) you would like to receive via email (select all that apply)

Property Tax Bill

Water and Sewer Bill

Municipal Address:

Telephone number:

Additional information/comments:

Authorization:

By submitting this form I confirm I am the account holder or secondary name listed on the account and I am authorized to make this change. By signing up for eBilling, I agree to all billing and collection practices as established by the Municipality of Brighton.

Signature

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Date