To sign-up to pre-authorized debit, fill out the form below and send a picture of a void cheque to [email protected].
You can also print out this PDF form, complete it, and send it with a void cheque to:
Coopérative Hydro Embrun Inc.
821 Notre Dame Street Suite 200
Embrun ON K0A 1W1
I shall inform the Payee, in a timely manner, of any changes to this Agreement.
I retain the right to revoke my authorization at any time, with a pre-notification of a maximum of 30 calendar days. To obtain a sample of the cancellation form or for more information on my right to cancel PAD Agreement, I may contact my financial institution or visit the Canadian Payments Association website at www.cdnpay.ca. I agree to release the financial institution of any liability if the revocation is not respected, except in the case of gross negligence on its part.
I agree that the financial institution at which I maintain the account is not required to verify that the payment is debited in accordance with this authorization. I also certify that every person whose signature is required for the operation of the aforementioned account has signed this authorization.
I acknowledge that the delivery of this authorization to the Payee constitutes delivery by me to the aforementioned financial institution.
I have certain rights of recourse if a debit does not comply with the terms of this Agreement. For example, I have the right to receive reimbursement for any PAD that is not authorized or that is not compatible with the terms of this PAD Agreement. For more information on my rights of recourse, I may contact my financial intstitution or visit www.cdnpay.ca
The financial institution shall reimburse me, on behalf of the organization, for any amounts withdrawn in error, within 90 calendar days of the withdrawal for a Personal PAD and within 10 business days for a Business PAD, provided that the reimbursement is claimed for a valid reason.
I understand that a claim to this effect must be made to my financial institution following the procedure it will provide for that purpose.
Finally, I acknowledge that a claim for reimbursement filled after the aforementioned time limits must be settled between me and Payee, without any liability or commitment on the part of my financial institution.
Send a personal cheque marked "VOID", to avoid errors in transcription, to [email protected] If you change your account or financial institution, please advice the payee organization.