Common use of Freedom of Information and Protection of Privacy Act Clause in Contracts

Freedom of Information and Protection of Privacy Act. The personal information on this form is being collected pursuant to 26(c) of the Freedom of Information and Protection of Privacy Act for the purposes of billing water customers in accordance with this contract and water system account management. For further information about this collection, you can contact the Privacy Officer at 250.352.8168, xxxxxxxxx@xxxx.xx.xx, or RDCK Privacy Officer, Box 000, 000 Xxxxxxxx Xxxxx, Xxxxxx, XX X0X 0X0. Account Holder Name: Requested Pre-Authorized Payment Plan Start Date: □ July 15, 2023 □ January 15, 2024 Account Number: (from water bill) Account Service Civic Address Account Holder Email Address: Account Holder Phone Number: I agree to the terms of this Water Pre-Authorized Payment Plan Customer Agreement. Account Holder Signature: Date: Please enclose a VOID CHEQUE or provide the following bank account information. The Water Account Holder must have signing authority on the bank account provided. Institution Number Transit Number Account Number RETURN FORM TO EITHER:

Freedom of Information and Protection of Privacy Act. The personal information on this form is being collected pursuant to 26(c) of the Freedom of Information and Protection of Privacy Act for the purposes of billing water customers in accordance with this contract and water system account management. For further information about this collection, you can contact the Privacy Officer at 250.352.8168, xxxxxxxxx@xxxx.xx.xx, or RDCK Privacy Officer, Box 000, 000 Xxxxxxxx Xxxxx, Xxxxxx, XX X0X 0X05R4. Account Holder Name: Requested Pre-Authorized Payment Plan Start Date: □ July 15, 2023 □ January 15, 2024 Account Number: (from water bill) Account Service Civic Address Account Holder Email Address: Account Holder Phone Number: I agree to the terms of this Water Pre-Authorized Payment Plan Customer Agreement. Account Holder Signature: Date: Please enclose a VOID CHEQUE or provide the following bank account information. The Water Account Holder must have signing authority on the bank account provided. Institution Number Transit Number Account Number RETURN FORM TO EITHER:

Freedom of Information and Protection of Privacy Act. The personal information on this form is being collected pursuant to 26(c) of the Freedom of Information and Protection of Privacy Act for the purposes of billing water customers in accordance with this contract and water system account management. For further information about this collection, you can contact the Privacy Officer at 250.352.8168, xxxxxxxxx@xxxx.xx.xx, or RDCK Privacy Officer, Box 000, 000 Xxxxxxxx Xxxxx, Xxxxxx, XX X0X 0X05R4. Account Holder Name: Requested Pre-Authorized Payment Plan Start Date: □  July 15, 2023 □ 2021  January 15, 2024 2022 Account Number: (from water bill) Account Service Civic Address Account Holder Email Address: Account Holder Phone Telephone Number: I agree to the terms of this Water Pre-Authorized Payment Plan Customer Agreement. Account Holder Signature: Date: Please enclose a VOID CHEQUE or provide the following bank account information. The Water Account Holder must have signing authority on the bank account provided. Institution Number Transit Number Account Number RETURN FORM TO EITHER:

Freedom of Information and Protection of Privacy Act. The personal information on this form is being collected pursuant to 26(c) of the Freedom of Information and Protection of Privacy Act for the purposes of billing water customers in accordance with this contract and water system account management. For further information about this collection, you can contact the Privacy Officer at 250.352.8168, xxxxxxxxx@xxxx.xx.xx, or RDCK Privacy Officer, Box 000, 000 Xxxxxxxx Xxxxx, Xxxxxx, XX X0X 0X05R4. Account Holder Name: Requested Pre-Authorized Payment Plan Start Date: □ July 15, 2023 2020 □ January 15, 2024 2021 Account Number: (from water bill) Account Service Civic Address Account Holder Email Address: Account Holder Phone Telephone Number: I agree to the terms of this Water Pre-Authorized Payment Plan Customer Agreement. Account Holder Signature: Date: Please enclose a VOID CHEQUE or provide the following bank account information. The Water Account Holder must have signing authority on the bank account provided. Institution Number Transit Number Account Number RETURN FORM TO EITHER: