Utilities E-Billing

2. Utilities E-Billing
   Please Note:
   
   - A $300.00 security deposit is charged on each residential account. If you sign up for pre-authorized payments AND e-billing, the deposit can be waived.
4. Utilities Account Number:*
6. First Name*
7. Last Name*
9. Address1*
11. City
12. Province
13. Postal Code
15. Mailing Address (if different from service address)
17. City
18. Province
19. Postal Code
21. Phone: *
    (xxx) xxx-xxxx
22. Cell:
    (xxx) xxx-xxxx
24. Primary Contact Person (if different from account holder):
25. Email:*
27. How we will use your information
    This personal information is being collected for purpose of administering a customer account database, and should you select to participate, for the electronic billing system and pre-authorized payment plan option with the City of Chestermere, and as such is deemed to be an activity of the City of Chestermere. The personal information is collected under the authority of Section 33(1)c of the Freedom of Information and Protection of Privacy Act, and will be used only for the purpose identified. If you have any questions or concerns about the collection or use of information you may contact the FOIP Coordinator at 105 Marina Road, Chestermere, AB T1X 1V7 or call (403) 207- 7050. The City may from time-to-time communicate directly with the primary contact person listed above through electronic means about your account, invoicing, and utility operations. In compliance with Canada's Anti-Spam Legislation we would like your consent to receive information on new programs and services and other communications such as special event notifications, service disruptions and customer surveys we send from time to time. If you wish to continue to receive communications from us, please indicate your consent by checking the box below. If we do not receive your consent we may be unable to continue sending you information about programs and new services, and other communications not directly related to your account. If you have any questions, or if you wish to withdraw your consent at any time, please feel free to contact the City at 403-207-7070 or email us at utilities@chestermere.ca with UNSUBSCRIBE E-BILLING in the subject line.
29. Electronic Billing (e-billing)
    E-billing is a simple and reliable way to receive your invoice. When you sign-up for e-billing service you will get a PDF of your utility bill sent directly to your email. There is no paper, no postage and no delay.
31. Yes, please sign me up to receive my utility bill electronically via email:*

    1. Yes
33. I, the undersigned, accept the following terms and conditions as part of the utility e-bill service. I understand that by enrolling in e-billing I will no longer receive a paper copy of my utility bill. A PDF attachment will be sent to the email address I have supplied. It is my responsibility to provide the correct email address and to inform the City of any changes. If I have not received my utility bill by the 15th of each month, I understand that I should contact the City. Non-receipt is not justification for late payment and penalties will apply. I further understand that I have the right to withdraw from e-billing and return to paper billing at any time by contacting the City.
35. Authorized Account Holder Signature: *
    Please type your name
36. Date: *
    Date:
40. To learn more about connecting with the City or to sign up for additional services, visit chestermere.ca/signup
Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field