Pre-Authorized Debit Agreement (PAD)Pre-Authorized Debit Agreement (Pad) • February 8th, 2023
Pre-Authorized Debit Agreement (PAD)Pre-Authorized Debit Agreement (Pad) • January 22nd, 2013
Account Holder (First & Last Name or Business name) : Address: Telephone no.: Account Co-holder (as applicable): Address: Telephone no. :
BUSINESS PAYOR'S PRE-AUTHORIZED DEBIT AGREEMENT (PAD)Pre-Authorized Debit Agreement (Pad) • August 2nd, 2019
We authorize the Payee indicated to draw a debit in paper, electronic or other form for the purpose of making payment for goods or services related to our commercial activities (a "Business PAD") on our account(s) and at the financial institution indicated on our provided banking instructions (the "Account" and the "Financial Institution") and we authorize the Financial Institution to honour and pay such debits. This Agreement and our authorization are provided for the benefit of the Payee and our Financial Institution and are provided in consideration of our Financial Institution agreeing to process debits against our Account in accordance with the Rules of the Canadian Payments Association. We agree that any direction we may provide to draw a Business PAD, and any Business PAD drawn in accordance with this Agreement, shall be binding on us as if signed by us, and, in the case of paper debits, as if they were cheques signed by us.
Complete All Sections BelowPre-Authorized Debit Agreement (Pad) • August 23rd, 2020
PRE-AUTHORIZED DEBIT AGREEMENT (PAD)Pre-Authorized Debit Agreement (Pad) • November 13th, 2019
CLIENT NAME, If other than the PAYOR: Client #:_ _ 1. PAYOR INFORMATION: Name: _ _ __ Address: _ _ __ City: _ Prov: Postal Code: _ Phone: _ __ 2. BANK ACCOUNT INFORMATION: Transit # : (5 digits) Financial Institution # : _ (3 digits) Account # : _ Financial Institution: _ _ _ _ _ Address: _ _ _ _ Chequing: _ _ Savings: 3. PRE-AUTHORIZED DEBIT (PAD) DETAILS: You, the Payor, authorize Victoria Lifeline to debit the bank account identified above for payment of yourInitial Payment $_ You, the Payor, authorize Victoria Lifeline to debit the bank account identified above for the ongoing Monthly Monitoring Fee $ You, the Payor, may revoke your authorization at any time in writing or by phone subject to provision of 30 days notice in accordance with the Victoria Lifeline Service Agreement. 4. WAIVER OF PRE-NOTIFICATION: You, the Payor, waive any and all requirements for pre-notification of debiting, including, without limitation, any changes in the amount of the PAD due to a se
Christian Missions Resource Centre Pre-Authorized Debit Agreement (PAD)Pre-Authorized Debit Agreement (Pad) • March 13th, 2013
PRE-AUTHORIZED DEBIT AGREEMENT (PAD) Desired date for direct debit (except 29, 30 and 31)DAYPre-Authorized Debit Agreement (Pad) • February 5th, 2019
A – Payor information Account holder Joint account holder Last name First name Last name First name Company name (if the account is that of a company) Address No. Street Apt. City Province Postal code Telephone E-mail Home Cell B – Bank account information Financial institution Name Address No. Street City Province Postal code Bank account Institution no. Branch transit no. Account no.
PRE-AUTHORIZED DEBIT AGREEMENT (PAD) FORMPre-Authorized Debit Agreement (Pad) • January 14th, 2021
I/we, the payor, authorizes the College of Licensed Practical Nurses of Prince Edward Island (CLPNPEI) to debit my specified bank account in the amount of $46.00 ($45.00 + $1.00 service fee) per month, payable in 10 monthly installments, on the first banking day of each month from April to January, to pre-pay my Licensed Practical Nurse registration fee for the following year. This authority is to remain in effect until the CLPNPEI has received written notification from me of any changes (i.e. change of banking account information) or termination. This notification must be received at least 30 days before the next debit is scheduled at the address below. I/we may obtain a cancellation form by contacting the CLPNPEI office. I/we have certain recourse rights if any debit does not comply with this agreement. For example, I/we have the right to receive reimbursement for any debit that is not authorized or is not consistent with this Pre-Authorized Debit (PAD) Agreement. To obtain more info
ContractPre-Authorized Debit Agreement (Pad) • August 30th, 2023
Pre-Authorized Debit Agreement (PAD)Pre-Authorized Debit Agreement (Pad) • February 26th, 2024
