Esend E-Billing Online Form

Print Feedback

Font Size: + -

Complete the enrolment/authorization form below. Make sure you fill in all your information correctly.

For questions regarding Esend please call the Accounts Receivable Clerk at 667-6401 or email receivables@whitehorse.ca

Please correct the field(s) marked in red below:

Please sign me up for

Utilities

Taxes

Both

AUTHORIZATION FORM

*

AUTHORIZATION FORM

Name

Email Address

Phone Number

Fax Number

Address

Address 2

City

Province

Postal Code

Utility / Tax Account Number(s):

TERMS AND CONDITIONS

This authorization may be changed at anytime with the submission of another authorization form.
E-Billing may be terminated at any time by the City of Whitehorse.
The information contained in this application form will be compiled and included in the City of Whitehorse Financial Information System database. The information in the database will only be accessed by employees of the City of Whitehorse, or agencies of the City of Whitehorse, who require the information to provide E-billing correspondence. No personal information, other than the information provided above, will be included in the Financial Information System database.
Payment of the Property Taxes and Utilities remain the responsibility of the Property Owner.

Do you agree with the above Terms and Conditions?

*

Yes

To receive a copy of your submission, please fill out your email address below and submit.
Email Address

To prevent spam we utilize a verification code system. Please enter the code as it is shown in the box below:

Code: