Transcription of Pre-Authorized Debit Agreement /Alternate …
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Example: bachelor of science
Pre-Authorized Debit Agreement /Alternate …
You authorize us to effect withdrawals from the account identified below in the amount of $ _____ payable _____ (frequency) beginning _____ and continuing until all amounts payable under the Loan/Lease are paid in full or this authorization is Debit Agreement / alternate Payment Authorization (for alternate Payor) for Indirect LendingLoan / Lease No:Bank Account InformationTransit NumberAccount NumberInstitution NumberI, _____ (borrower) request that Scotiabank accept payments on Loan/Lease # _____from _____ ( alternate Payor) until such time that I advise you otherwise for payment of all amounts payable under the contract identified below to Scotiabank under this Pre-Authorized Payment Plan. The alternate Payor hereby acknowledges that they will be paying the sums due and owing on behalf of the borrower set out above. 2154311 (11/15) Borrower: DateAddressPre authorized Payment Agreement for Contract of Sale in Instalment (CSI), Conditional Sale Agreement (CSA), Credit Agreement (CA) or Retail Lease Agreement (Lease)SignaturePrint Name PersonalBusinessAlternate PayorBank AddressNOTE: Please attach a sample of your cheque with VOID written on it (if available) alternate Payor Authorization I,_____ (borrower) acknowledge and agree that I continue to be liable for all obligations owing.
You authorize us to effect withdrawals from the account identified below in the amount of $ _____ payable _____ (frequency) beginning _____ and continuing until all amounts payable under the
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