Form Builder - City of Sarnia

Required fields are marked with asterisks (*)

Pre-Authorized Tax Payment Plan Application Form


Before registering for a pre-authorized payment plan, please ensure the property:

  • has no arrears on account
  • is fully assessed

Registration is required by the 20th day of the month to be effective for the current month’s withdrawal.

Property Owner Information

For verification purposes, please include one void cheque or pre-authorized debit form per application.

Line of credit accounts are not accepted.


Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Payment Plan Option

Please select one payment plan option:


I/We hereby authorize the City of Sarnia to withdraw pre-authorized payments, as indicated above, from my/our bank account, for payment property taxes


*If more than one signature is required for your bank account, all parties must sign*