Scribd Logo
Upload

Welcome to Scribd!

  • 226 views

    Please Complete and Return This Form With A Void Cheque To Customer Care Centre by Mail, Fax or Email

    Uploaded by

    Amirhoosein Meshgini
    This document is a pre-authorized payment agreement for a Metergy Solutions Inc. account. It collects customer information such as name, address and bank details. The customer authorizes Metergy to debit their bank account each month for the amount due on the bill. The customer can cancel the agreement by giving 30 days notice. Metergy will issue monthly bills due 20 days later and obtain authorization for any other payments. The agreement governs payment and not cancellation of services.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Please Complete and Return This Form With A Void Cheque To Customer Care Centre by Mail, Fax or Email

    Uploaded by

    Amirhoosein Meshgini
    226 views1 page
    This document is a pre-authorized payment agreement for a Metergy Solutions Inc. account. It collects customer information such as name, address and bank details. The customer authorizes Metergy to debit their bank account each month for the amount due on the bill. The customer can cancel the agreement by giving 30 days notice. Metergy will issue monthly bills due 20 days later and obtain authorization for any other payments. The agreement governs payment and not cancellation of services.

    Original Title

    Metergy-PAP Form_Dec2020

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document is a pre-authorized payment agreement for a Metergy Solutions Inc. account. It collects customer information such as name, address and bank details. The customer authorizes Metergy to debit their bank account each month for the amount due on the bill. The customer can cancel the agreement by giving 30 days notice. Metergy will issue monthly bills due 20 days later and obtain authorization for any other payments. The agreement governs payment and not cancellation of services.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    226 views1 page

    Please Complete and Return This Form With A Void Cheque To Customer Care Centre by Mail, Fax or Email

    Uploaded by

    Amirhoosein Meshgini
    This document is a pre-authorized payment agreement for a Metergy Solutions Inc. account. It collects customer information such as name, address and bank details. The customer authorizes Metergy to debit their bank account each month for the amount due on the bill. The customer can cancel the agreement by giving 30 days notice. Metergy will issue monthly bills due 20 days later and obtain authorization for any other payments. The agreement governs payment and not cancellation of services.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 1

    PRE-AUTHORIZED PAYMENT AGREEMENT

    Please complete and return this form with a void cheque to


    Customer Care Centre by mail, fax or email.

    Fields marked with an asterisk (*) are required.

    The following pre-authorized payment agreement must be completed by the primary Metergy Solutions Inc. account holder.

    PART A: CUSTOMER INFORMATION


    Account Number*: Type of Account*:

    Primary Account Holder: Mr Mrs Miss Ms (Please Circle) First Name*: Middle Name: Last Name*:

    Primary Phone: Secondary Phone: Email:

    Service Address*: Number, Street Name, Unit Number City*: Province*: Postal Code*:

    Mailing Address: (If different from above) Number, Street Name, Unit Number City: Province: Postal Code:

    PART B: BANKING INFORMATION


    Bank Account Holder: (Name on cheque must match Metergy Solutions Inc.’s primary account holder who is financially responsible for the account, as specified above)
    First Name*: Middle Name Last Name*:

    Financial Institution*: Financial Institution Number*: (3 digits)

    Transit (Branch Number)*: (5 digits) Bank Account Number*: (7 or more digits)

    PART C: TERMS OF AGREEMENT

    I authorize Metergy Solutions Inc. and its affiliates and agents (collectively, “Metergy”) and the financial institution designated herein (or any other financial institution I
    may authorize at any time) to begin debits, as per my instructions, for monthly regular variable recurring payments and/or one-time payments from time to time, for
    payment of all charges arising under my Metergy account(s). Regular variable monthly payments for the full amount of the services delivered will be debited from my
    specified account on the due date and in the amount indicated on the Metergy monthly bill. Metergy will issue regular monthly bills with a due date being twenty (20)
    days after the bill creation date. Metergy will obtain my authorization for any other one-time or sporadic debits.

    I may change or revoke my authorization at any time, subject to providing notice to Metergy at least thirty (30) days before the next debit is scheduled. To obtain a
    sample cancellation form, or further information on my right to cancel a Pre-authorized Debit (“PAD”) Agreement, I may contact my financial institution or visit
    www.payments.ca.

    Metergy may not assign this authorization, whether directly or indirectly, by operation of law, change of control or otherwise, without providing at least ten (10) days
    prior written notice to me. I understand and acknowledge that this agreement solely governs the method of payment for charges arising under my Metergy account.
    Cancellation of this agreement does not constitute cancellation of services by Metergy nor in any way affect my obligation to pay for any and all charges associated
    with my Metergy account. I have certain recourse rights if any debit does not comply with this agreement. For example, I have the right to receive reimbursement for
    any debit that is not authorized or is not consistent with this PAD Agreement. To obtain more information on my recourse rights, I may contact my financial institution or
    visit www.payments.ca.

    Authorized Signature for personal or business** accounts*: Date*:

    ** I have the authority to bind the corporation.

    Please complete and return this form with a void cheque to the Metergy Customer Care Centre by mail, fax or email.

    Mail: Metergy Solutions Inc.


    Customer Care Centre,
    PO Box 4638, Station A,
    Toronto, ON, M5W 5C7
    Fax: 1-416-649-1969
    Email: [email protected]

    The information collected on this form is for the sole purpose of providing our customers with sub-metering services and for the collection of our customer accounts. A copy of the
    Metergy Privacy Policy is available at www.Metergysolutions.com or can be obtained by contacting Customer Care at 1-866-449-4423.

    TM
    of Metergy Solutions Inc.

    PAP-DEC 2020

    You might also like