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Cancellation of Authorized Utilities Payment Plan

Please fill out and sign the form below. (Use your mouse or touchscreen in the signature box)


This personal information is being collected for the Town of Stony Plain under the authority of Section 33c of the Freedom of Information and Protection of Privacy (FOIP) Act and will be used to collect information regarding Stop Monthly Installment Payment. The personal information provided will be protected in accordance with Part 2 of the Act. If you have any questions regarding the collection, use and disclosure of personal information, please contact the FOIP Coordinator at 780-963-2151.