PRE-AUTHORIZED DEBIT Friendly, Simple and Convenient Payment Option
At GTFC, we are pleased to provide a range of convenient and environmentally friendly payment options. Paying using Pre‐Authorized Debit option is:
Friendly – no writing cheques or bank visits Simple – sign up and your payment will always arrive on time Convenient – ensures no disruption in services Just follow the three simple steps below to enroll in our Pre‐Authorized Debit payment option.
Types of services: PersonalBusiness
Date
BANK INFO
CheckingSavings
PAYMENT INFO
Frequency: MonthlyOne‐Time
Withdrawal Day & Amount: 5th of the Month10th of the Month
The Terms and Conditions are located on the other side of this page. Please read through them carefully and provide the account holder(s) signature for the bank account in the designated area.
Provide us with this form and a void cheque. Please note, all void cheques will be securely disposed of upon successful enrollment into the Pre‐Authorized Debit Plan.
By signing this form…
I grant authority to Global Taxes & Financial Consulting (GTFC) and my bank to withdraw from my bank account each month the full amount of my regular monthly recurring payment(s) and/or one‐time payments for charges arising under my Agreement with GTFC (provided any one‐time payment not contemplated in my Agreement shall be specifically authorized by me), upon the due date in accordance with the rules of the United States of America Payments Association. I acknowledge that the amount of my regular monthly recurring payment(s) will not change unless notified based on my services consumption. However, I do authorize GTFC to withdraw any outstanding fees that I may owe pursuant to the terms of my Agreement. This Pre‐Authorized Debit shall remain in effect until I give GTFC written notice to cancel it. Which shall mean, GTFC will not be held liable for performing any services for which the service charge was being billed. I must provide 30 days written notice to cancel this PAD form. My bank information on this form and signatures below are correct. I will notify GTFC of any change in the account information that may occur. I also agree that any Non‐Sufficient Funds Fee occurred during this agreement will also be my responsibility to pay to GTFC. Due to any outstanding fees, GTFC holds the right to stop its services till balance is paid in full through Pre‐Authorized Debit or Cashier Cheque or Money Order. I warrant and guarantee that all persons whose signatures are required to sign on this bank account have signed this agreement. I consent to GTFC collecting, using and disclosing this information for the purpose of establishing a Pre‐ Authorized Debit (“PAD”) plan, which will be applied against my GTFC Client Services account. I acknowledge that this form is personal, and GTFC’s processing Financial Institution is not required to verify that a PAD has been issued in accordance with the particulars of the Payer’s PAD agreement including, but not limited to, the amount. I hereby waive my right to receive pre‐notification of the amount of a debit and agree that I do not require advance notice of the amount of a debit before the debit is processed. I acknowledge that GTFC has the right to correct any billing error and I will then receive a forward credit or debit on my bill (GTFC will not provide refunds). I have certain recourse rights if any debit does not comply with this PAD form. For example, I have the right to receive reimbursement for any PAD that is not authorized or is not consistent with this PAD form. To obtain a form for a Reimbursement Claim, or for more information on my recourse rights, I may contact my financial institution. Revocation of this authorization does not terminate my contract for services that exists between GTFC and myself. The Payer’s PAD agreement applies only to the method of payment and does not otherwise have any bearing on the contract for services exchanged.
Sign and date here
If account is a joint account, second account holder must sign here
