Longworth Properties Limited

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902 897 7777

468 Prince Street, Truro Nova Scotia

PAYMENT CHANGE REQUEST

We will do our best to accommodate your request and make the change prior to your scheduled due date. We do NOT guarantee that the change will be completed. Any late or NSF fees incurred are the responsibility of the tenant. Absolutely no changes can be made on the same day as a scheduled payment.

Full Name

Building Address

Apartment Number

Phone

Rent Amount

Requested Payment Amount Change

Due Date

Requested Payment Date Change

One time only change?

Yes

New banking info?

Upload an image of your void cheque or preauthorized payment information.

Please provide a brief explanation for the request.

By submitting this form, I understand that this is only a request for a payment change and understand that Longworth Properties Limited may not be able to complete the requested change.