PRE-AUTHORIZED DEBIT (PAD) AGREEMENT This donation is made on behalf of a (n):
Individual
Business
Church
General Information Full Name:
First
Middle
Last
Organization/ Business Legal Name: Address Street:
Unit No.
City:
Postal Code:
Main Phone:
Email Address:
Province:
* Annual tax receipts will be sent in February at the email address you provide, unless otherwise requested.
Check the box below to receive KAC’s ministry updates, newsletters and prayer bulletins via email: YES! Please add me to Kids Alive Canada`s mailing list. (You can unsubscribe at any time)
Donation Details Amount: Reason for Giving:
Frequency: Child Sponsorship
One-Time
Monthly
Program Support
Quarterly
Missionary Support
Other (Please Specify) Payment Start Date:
Immediately OR
On (MM/DD/YYYY)
Payment End Date:
Until I provide notice of cancellation OR
on (MM/DD/YYYY):
Account Information Account Holder Full Name: Account Type: (Select one)
Chequing
Savings
Please select one of the following options: Please use the bank account information currently on file with Kids Alive Canada. I have attached a void cheque or Direct Deposit form from my bank. Please use the following account information: Bank #:
Branch #:
Account #: Transit #:
Annually General Giving
I/we authorize Kids Alive Canada (KAC) to debit the bank account identified above for the amount indicated, at the frequency specified and beginning on the date noted above. KAC will obtain my/our authorization for any other one-time or regular recurring debits. I/we warrant and guarantee that all persons whose signatures are required to authorize withdrawals from the account have signed this Authorization. This authority is to remain in effect until Kids Alive Canada has received written notification from me/us of changes or termination. I/we understand that this notification must be received by KAC at the mailing address or email address provided below at least fifteen calendar days before the next charge is scheduled. I/we may obtain a sample cancellation form, or more information on my/our right to cancel a PAD Agreement at my financial institution or by visiting www.cdnpay.ca. I/we agree that by signing this PAD Agreement I/we do not require advance notice of the amount or date of the first PAD to be made from my/our account. If any PAD is dishonoured by my/our financial institution for any reason, including ‘non-sufficient funds’ or ‘funds not cleared’, KAC is entitled to re-attempt the PAD electronically on a one-time only basis for the same amount as the original debit without advance notice and such item may only be re-presented within 30 days of the failed or dishonoured debit. I/we undertake to provide KAC with updated account information no later than 15 days prior to the next authorized debit should any of the account information listed here change while this PAD Agreement is still in effect. In the event that the amount of this PAD changes, KAC will provide me/us with written notice identifying the new amount at least 30 calendar days before the first PAD for that amount. I/we have certain recourse rights if any debit does not comply with this agreement. I/we have the right to receive reimbursement for any PAD that is not authorized or is not consistent with this PAD Agreement. To obtain a form for a Reimbursement Claim, or for more information on my/our rights, I/we may contact my/our financial institution or visit www.cdnpay.ca.
Check the box below to receive KAC's ministry updates, newsletters and prayer bulletins via email: YES! Please add me to Kids Alive Canada`s mailing list.
Jun 2, 1998 - In digitally televised systems such as video-telephone, teleconference .... The above and other objects and features of the present invention Will ...
Jun 2, 1998 - Primary Examiner * Allen Wong. (57). ABSTRACT. A method for padding interlaced texture information on a reference VOP to perform a motion ...
I release Jefferson County School District staff from all liability for any injury caused by the administration of the medication in compliance with medication label.
Retrying... Stipulation of Agreement to Negotiate Agreement to Arbitrate.pdf. Stipulation of Agreement to Negotiate Agreement to Arbitrate.pdf. Open. Extract.
Oct 10, 2013 - Company registered under the Companies Act 1956, having its registered ...... brings an alternative purchaser for the said apartment, the Vendor No.1/Developer ..... capacity) per block with rescue device and V3F for energy.
Phonosurgeons of India - Phonocon 2013 on 8th, 9th and 10th March 2013 at Dr. ... The College was managed by Siddhartha Academy of General ... It is our privilege to be entrusted with hosting the 9th Annual Conference at Vijayawada.
There was a problem previewing this document. Retrying... Download. Connect more apps... Try one of the apps below to open or edit this item. Recette pad ...
Apr 16, 2014 - Acquired Affiliates (if any), of Redistributable Copies of software sold, offered for sale, or .... under Section 1.1(a)(i) with respect to at least one Triggered Patent of .... Affiliate of a LOT User, then (i) all Licenses granted he
years, Occ.: Private Service, R/o. Plot No. 17, R. R. Nagar, BHEL Lane, Srinagar. Colony, Old Bowenpally, Secunderabad. Vendor No.2 Rep. by his GPA holder M/S. APARNA CONSTRUCTIONS AND. ESTATES PRIVATE LIMITED a Company registered under the Companies
Email: [email protected] ... tool to have both a pre-install check as well as a means of interacting with the automated CORD install to report back test ...
Jun 1, 2010 - to verify compliance with this, and to be seen by an addiction specialist if requested. _ I agree to attend and ... ______. Prescriber Signature. Date.
Gramm-Leach-Bliley Act, (iii) your billing statement, if you have signed up to ... or mobile alerts), unless you also provide your consent to receive electronic communications. ... Additionally, you may call customer service at the number on your cre
Phone: Appointment Date: Appointment Time: Service Provider and ... license to use a reasonable number of images created under this Agreement as âsamplesâ.
Jun 1, 2010 - ... grounds for the prescriber to stop prescribing opioid therapy at any time. ______. Patient Signature. Date. ______. Prescriber Signature. Date.
It is just a template to exchange ... Email: Brian. ... tool to have both a pre-install check as well as a means of interacting with the automated CORD install to ...
âConsent Agreementâ means an agreement by a Person acquiring Units who is not .... judicial order or other legal process (such as a transfer in connection with ...
âClientâ means the person, who is availing or intends to avail the services of .... Branch and will upgrade the trading software, as may be necessary from .... expiry of four days from the dispatch thereof in case other party refused to accept th