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Pre-Authorized Credit Card Payments - Water/Sewer
I hereby authorize the City of Miramichi to charge the amount equal to the quarterly water and sewage invoice (pay on due date), for the following address. I understand that I will need to provide payment information, in person or by phone, to the city to finalize the pre-authorization.
12 Digit Water/Sewer Account Number:
Name:
First Name
Last Name
Property owner (if different from above)
First Name
Last Name
Service Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mailing Address (If Different From Service Address):
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Email:
example@example.com
Property Owner Signature:
Submit
Should be Empty: