Fillable Tax & Utility Prepayment Plan Amendment Form (District of North Vancouver)

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Tax & Utility Prepayment Plan Amendment Form (District of North Vancouver)

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The Tax & Utility Prepayment Plan Amendment Form (District of North Vancouver) form is 2 pages long and contains:

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  • 4 check-boxes
  • 22 other fields

Country of origin: CANADA
File type: PDF

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Tax & Utility Prepayment Plan Amendment Form
D i s t r i c t o f N o r t h V a n c o u v e r
Revenue & Taxation Department
355 West Queens Rd, North Vancouver, BC V7N 4N5
Questions about this form: Phone: 604-990-2311 or Email: propertytax@dnv.org
Form submission: Mail or Email to address above or Fax: 604.987.7160
COMPLETION: To ensure legibility, please complete (type) online then print. Sign the printed copy
and submit to the department and address indicated above.
CHANGES OR CANCELLATIONS TO THE TAX & UTILITY PREPAYMENT PLAN MUST BE
RECEIVED A MINIMUM 10 DAYS PRIOR TO A SCHEDULED PAYMENT DATE.
Folio:
Civic address:
Select one of the following four options:
1. CANCEL THE PREPAYMENT PLAN
2. CHANGE BANK ACCOUNT INFORMATION
(Please attach a void cheque and fill in the information below)
Name of Financial Institution:
Address of
Financial Institution:
Branch # (5 digits):
Institution # (3 digits):
Account #:
3. CHANGE DOLLAR AMOUNT
From: $
To: $
4. CHANGE HOMEOWNER GRANT ELIGIBILITY (select eligibility)
Basic Grant
Additional Grant
Not Eligible
DOC# 1798922
Year of Birth: ________
Tax & Utility Prepayment Plan Amendment Form
www.dnv.org Page 2 of 2
I /we hereby authorize the District of North Vancouver to make the above selected change to
my/our Tax & Utility Prepayment Plan effective:
Immediately
OR
Date
The personal information collected on this form is done so pursuant to the Community Charter and/or the Local
Government Act and in accordance with the Freedom of Information and Protection of Privacy Act. The personal
information collected herein will be used only for the purpose of processing this application or request and for no
other purpose unless its release is authorized by its owner, the information is part of a record series commonly
available to the public, or is compelled by a Court or an agent duly authorized under another Act. Further information
may be obtained by speaking with The District of North Vancouver’s Manager of Administrative Services at
604-990-2207 or at 355 W Queens Road, North Vancouver.
Name
Date
Mailing address
Phone number
Signature
OFFICE USE ONLY
RECEIVED DATE STAMP
DOC# 1798922
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Tax & Utility Prepayment Plan Amendment Form (District of North Vancouver)

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Completed 3 April 2021

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