2. E-Tax Notice Service Agreement
4. Property Tax Roll Number(s): List rolls you would like to receive e-statements for:*
6. First Name*
7. Last Name*
9. Phone: *
   (xxx) xxx-xxxx
10. Email:*
12. Property or Service Address*
14. City
15. Province
16. Postal Code
18. Additional Address (if needed)
20. City
21. Province
22. Postal Code
24. 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 taxes@chestermere.ca with UNSUBSCRIBE E-NOTICES in the subject line.
26. Electronic Tax Notices
    The City offers electronic delivery of tax related notices for your convenience. When you sign-up you will get a PDF of your notice sent directly to your email. There is no paper, no postage and no delay.
28. Yes, please sign me up to receive my Tax notices electronically via email:*

    1. Yes
30. I, the undersigned, accept the following terms and conditions as part of the e-notice service. I understand that by enrolling I will no longer receive a paper copy of my Tax Notice. 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. Non-receipt is not justification for late payment and penalties will apply. I further understand that I have the right to withdraw from e-notices and return to paper billing at any time by contacting the City.
32. Authorized Account Holder Signature: *
    Please type your name
33. Date: *
    Date:
37. To learn more about connecting with the City or to sign up for additional services, visit chestermere.ca/signup
Leave This Blank:


39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit

* indicates a required field