Payor's PAD Agreement

Please fill in the form below to complete the Pre-authorized Debit Plan Agreement

Date:

Date Picker


Name(s): Email:

Condo Corporation:

Account/Unit #:

Type of Service: Business OR Personal

Address:

City:

Province

Postal Code:


Business Phone:

Home Phone:


 

Financial Institution

Name:

Account Number: Transit Number:

Address:

City:

Province

Postal Code:


Authorized Signature(s):

Signed:

Signature (as it appears on the cheque)

Dated:

Date Picker

 


Signed:

Signature (as it appears on the cheque)

Dated:

Date Picker