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Automatic Payment Registration and Change Form with Basic Payment and Equal Payment Plan options

Fill in and submit this form to register or change your information for automatic payment(pre-authorized debit) from your bank account.

You will have two options for deductions:
1. Basic Payment Plan - The full amount of your bill will be deducted from your bank account on the due date of your bill
2. Equal Payment Plan - The same amount will be deducted from your bank account every month on the date you select

Fields marked with an asterisk(*) must be completed

Step 1 - Add Alectra Utilities (formerly Guelph Hydro) Account Holder Information

Alectra Utilities (formerly Guelph Hydro) Account Holder Information

* Current account Number (as it appears on your bill)

* Last name

* First name

* Email address

* Confirm Email address

* Home Phone Number (999-999-9999)

Mobile Phone Number (999-999-9999)

Step 2 - Add Service Profile Information

Service Profile Information

Service address under the contract for which you are the account holder.

* Street Number

* Street Name

Unit/Suite/Apt

* Street Type

Street Direction

* City

Guelph Rockwood

* Postal Code/Zip

My Mailing address is the same as my new service address? Yes No

* Street Number

* Street Name

Unit/Suite/Apt

* Street Type

Street Direction

* Postal Code/Zip

* City

* Prov/State

* Country

Step 3 - Add Pre-Authorization Plan Details

Pre-Authorization Plan Information

* Residential or Business Service

Select Residential Business

* Type of Plan

Select Basic Payment Plan - full payment withdrawn on the due date Equal Payment Plan - available to residential customers only

Basic Payment Plan - full payment withdrawn on the due date. This is the only option available for businesses.

Depending on your billing cycle, Alectra Utilities (formerly Guelph Hydro Electric Systems Inc.) will determine one of the following days that best aligns your billing date with your bank withdrawal date. There are three billing cycle scenarios that can exist. For each possible scenario, please choose the day that would be your preference.

* Scenario 1

1st of month 5th of month

* Scenario 2

10th of month 15th of month

* Scenario 3

20th of month 25th of month

Step 4 - Add Banking Information

Banking Information

Please be advised that pre-authorized payments cannot be drawn on a line of credit or savings account.

* Name of Bank

* Bank Street Number

* Bank Street Name

Bank Unit/Suite/Apt

* Bank Street Type

Bank Street Direction

* Bank City

* Bank Postal Code/Zip

Please note the location of the bank transit number, bank code and account number. Typically, the first three digits of your cheque is the cheque number. The second set of values are the bank transit number which identifies the location of your bank branch. The third set of numbers (typically three digits) represents the bank. Typically, the last set of numbers represent your account number. If you are not sure which values to use, please contact your bank for an explanation of where to locate the required cheque information. Most banks will have online examples explaining how to locate the transit number, bank number and account number on your cheque.

* Bank Transit Number(Branch)

* Bank Code Number (usually three digits found between bank transit number and account number)

* Account Number

Step 5 - Terms and Conditions

1) Definitions  a)“I”, “me”,“we”, “us”, “my”, “our” refers to each holder of the PAD agreement  b) “you” and “your” refers to Guelph Hydro Electric Systems Inc. (GUELPH HYDRO) 2) Acknowledgements  a) By signing below, I/we authorize ALECTRA UTILITIES (formerly GUELPH HYDRO) to debit the aforementioned PAD account set out above for the purpose of payment of all charges arising under my/our ALECTRA UTILITIES (formerly GUELPH HYDRO) account for all amounts owed to you by us from time to time and, in the event this is a change to an existing authorization agreement, to cease debiting the PAD account we previously established for this purpose  b) This authorization will remain in effect until GUELPH HYDRO has received written notification of its change or termination (see cancellation rights below)  c) By confirming below, I/we acknowledge that cancellation of the pre-authorized payment plan does not relieve me/us of any obligation to pay all amounts owing to ALECTRA UTILITIES (formerly GUELPH HYDRO). Cancellation of the pre-authorized payment plan does not constitute cancellation of services with GUELPH HYDRO and I/we shall be liable for any past, present or future amounts owing. For information about how to cancel your ALECTRA UTILITIES (formerly GUELPH HYDRO) account, please visit www.guelphhydro.com  d) By confirming below I/we acknowledge that the amounts to be drawn against our PAD account may vary in accordance with amounts billed to us by GUELPH HYDRO and that in the case of equal payment plans may include periodic and/ or annual adjustments and we authorize ALECTRA UTILITIES (formerly GUELPH HYDRO) to draw such amounts without any pre-notice or other consent by us. For information about equal payment plans, please visit www.guelphhydro.com  e) I/we acknowledge that cancellation of pre-authorized payment under an equal payment plan constitutes termination of the equal payment plan and all monies owed become due and payable upon cancellation  f) In the event of any pre-authorized debit being returned for any reason (including insufficient funds), the account holder shall be obligated to pay ALECTRA UTILITIES (formerly GUELPH HYDRO) an NSF fee and ALECTRA UTILITIES (formerly GUELPH HYDRO) reserves the right to remove any customer from this plan for returned payments  g) ALECTRA UTILITIES (formerly GUELPH HYDRO) endeavours to process payment within three (3) business days of the due date/equal payment plan date, however, there can be no guarantee of the date payment will be processed 3) Accuracy  a) I/we warrant on a continuing basis that all persons whose signatures are required to deal with the PAD account have signed this PAD authorization and that the information set out above is accurate and complete  b) I/we will notify you in writing (by completing a new PAD authorization) of any changes at least ten (10) business days prior to the next scheduled debit 4) Cancellation Rights  a) I/we have the right to cancel this agreement at any time, by giving you at least ten (10) business days written notice  b) I/we may cancel our account by submitting an updated PAD agreement. Alternatively, I/we may obtain a sample cancellation form or further information regarding my/our right to cancel a PAD agreement at my/our financial institution or by visiting the Canadian Payment Association 5) Recourse Rights  a) I/we have certain recourse rights 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 consistent with this PAD agreement. To obtain a form for reimbursement claim, or for more information on my/our recourse rights, I/we may contact my/our financial institution or visit the Canadian Payment Association.

I/we confirm to you that I/we have read, understand and agree to the Terms and Conditions of this PAD Agreement. I/We herby waive any requirement for pre-notificaiton of changes in the amounts and/or payment dates of PADs drawn against my/our account at my/our financial institution in accordance with this authorization. By submitting this form, I acknowledge that the personal information contained on this form is collected by Alectra Utilities 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 electricity distribution license. Use and disclosure of the personal information shall be governed by the Municipal Freedom of Information and Protection of Privacy Act. Questions about this collection should be directed to Alectra Utilities' Privacy Officer, 2185 Derry Road West, Mississauga, ON L5N 7A6; email: privacy.officer@alectra.com No Yes