Please complete the Pre-Authorized Debit (PAD) Plan agreement below.Authorized Debit Agreement • August 31st, 2015
Contract Type FiledAugust 31st, 2015This authority is to remain in effect until Westland Insurance Group Ltd. has received written notification from me/us of its change or termination. This notification must be received at least ten (10) business days before the next debit is scheduled at the address provided below. I/we may obtain a sample cancellation form, or more information on my/our right to cancel a PAD agreement at my/our financial institution or by visiting www.payments.ca.