PRE-AUTHORIZED BILL PAYMENTS - uknow2

1 PRE-AUTHORIZEDBILL PAYMENTSFREE UP YOUR TIME FOR MORE IMPORTANT # W10164 ROG_577_PAP_ON_EN:5006-455RW_PAPBro_ON_E N 5/1/08 8:34 AM Page 1 Please select the Rogers account(s) you would like to place on PRE-AUTHORIZED bill PAYMENTS : WIRELESS CABLE HOME PHONE INTERNETP lease complete all required information as identified by *ACCOUNT HOLDER NAME(S)*HOME TELEPHONE #* WIRELESS PHONE #ADDRESS*CITY/TOWN* PROVINCE* POSTAL CODE*ROGERS ACCOUNT(S) # For PRE-AUTHORIZED Bank Account PAYMENTS :BANK NAME* BANK BRANCH NUMBER* Example: 12345 BANK NUMBER* BANK ACCOUNT NUMBER*Example: 002 Example: 1234567 BANK ADDRESS*CITY/TOWN* PROVINCE* POSTAL CODE*A sample cheque marked VOID has been enclosed.

2 * Signature and date required below.*This authorizes any of the Rogers group of companies ( Rogers ) to debit my/our account shown above to pay my/our periodic charges for the provision of Rogers goods and/or services, including all services provided by Rogers Wireless Partnership and all services (including Rogers Internet and Rogers Home Phone services) provided by Rogers Cable Communications acknowledge that this authorization is for the use of Rogers and my/our financial institution and is provided in consideration of my/our financial institution agreeing to process debits against my/our account as per the rules of the Canadian PAYMENTS Association.

3 I/We acknowledge that by providing and delivering this authorization to Rogers constitutes delivery by me/us to my/our financial institution. The information on this form will be communicated to Rogers bank(s) in order to implement this authorization. All persons whose signatures are required to sign on the account noted above have signed this authorization. I/We will promptly notify Rogers in writing if there is any change to my/our account authorization may be cancelled at any time with at least 15 days prior written notice to Rogers.

4 Cancellation of this authorization applies only to the method of payment and does not otherwise have any bearing on the contract for Rogers goods or services. I/We waive pre-notification of the amounts and dates of any variable debits from my/our understand that:I/We will receive written notice of the initial amount to be withdrawn from my/our account on a monthly basis and prior written notice of any changes in the amount to be financial institution is not required to verify that any debits Rogers withdraws comply with this authorization or any agreement with Rogers.

5 My/Our financial institution can reimburse me/us for any debited amount if: (i) its withdrawal does not comply with this authorization, or (ii) I/we cancel this authorization. To be reimbursed, I/we must complete a declaration form within 90 calendar days of the debit being posted to my/our account; any dispute after that time must be resolved directly with acknowledge that I/we have read, understood and accepted all of the terms and conditions of this PRE-AUTHORIZED bill PAYMENTS Authorization Request DATESIGNATURE DATEFor PRE-AUTHORIZED Credit Card PAYMENTS : To set up your Rogers account on PRE-AUTHORIZED credit card PAYMENTS , please visit OR call the Customer Servicephone number noted on your PRE-AUTHORIZED bill PAYMENTS REQUEST FORMM oisten, Seal and MailROGERS PRE-AUTHORIZEDBILL PAYMENTS Trademarks of Rogers Communications Inc.

6 Used under license, or of Rogers Wireless or Rogers Cable. more more stamps. No more bother. Just the convenience of automatic monthly PAYMENTS !LIFE IS BUSY TIME BY PAYING YOUR bill THE EASY WAY!Sign up for Rogers PRE-AUTHORIZED bill PAYMENTS today and enjoy the peace of mind of knowing your Rogers bill will be paid automatically and on time each month. That s one less thing to do and one less thing to think about!You ll still receive a monthly Rogers statement for your records and your PAYMENTS will be automatically recorded in your passbook, monthly statement or Internet banking place your Rogers account(s) on PRE-AUTHORIZED bill PAYMENTS , just complete and sign the attached and include a sample cheque marked VOID.

7 Then simply moisten and seal the edges of this brochure to make it into a postage-paid envelope and drop it in the mail to MCC# W10164 TMROG_577_PAP_ON_EN:5006-455RW_PAPBro_ON _EN 5/1/08 8:34 AM Page 2