Signature of Account Holder. Signature of Joint Account Holder (if applicable): Name (please print): Name (please print): Date: Date: PAD AGREEMENT - ADDITIONAL INSTRUCTIONS
Signature of Account Holder. Name (Please print) Date Signature of Joint Account Holder (if appropriate) Name (Please print) Date You have certain recourse rights if any debit does not comply with this agreement. For example, you have the right to receive reimbursement for any debit that is not authorized or is not consistent with this PAD Agreement. To 7 obtain more information on your recourse rights, contact your financial institution or visit xxx.xxxxxx.xx. When the form is complete, mail or fax to: XYZ Telecommunications
Signature of Account Holder. Signature of Joint Account Holder (if applicable) Name(s) (please print)
Signature of Account Holder. Signature of Joint Account Holder (if applicable) _____________________________________ _____________________________________ Name: ______________________________ Name: _______________________________ (Please print) (Please print) Date:________________________________ Date: _______________________________ You have certain recourse rights if any debit does not comply with this agreement. For example, you have the right to receive reimbursement for any debit that is not authorized or is not consistent with this agreement. To obtain more information on your recourse rights, contact your financial institution or visit xxx.xxxxxx.xx. 00 Xxxxxxxx Xxxx, Xxxxxxx, XX X0X 0X0 | 416-686-6809 | xxx.xxxx.xx
Signature of Account Holder. Date Signature of Joint-Account Holder Date IMPORTANT: Attach a personal cheque marked “VOID” to avoid errors in transcription
Signature of Account Holder. Signature of Joint Account Holder (if applicable) Today’s Date (month / day / year) Elora Road Christian Fellowship Inc. 0000 Xxxxxxxxxx Xxxx 0, Xxxxxx, XX X0X 0X0 Phone: 0-000-000-0000 E-mail: xxxxxxx@xxxx.xx
Signature of Account Holder. Signature of Joint Account Holder: Name: Name: Date: Date: You have certain recourse rights if any debit does not comply with this agreement. For example, you have the right to receive reimbursement for any debit that is not authorized or is not consistent with this PAD Agreement. To obtain more information on your recourse rights, you may contact your financial institution or visit xxx.xxxxxx.xx When the form is complete, email, mail or fax to: UMEI Christian High School 000 Xxxxxx Xx. 0, XX#0, Xxxxxxxxxx, XX X0X 0X0
