Sample Void Cheque

I (we), as the account holder(s), authorize Renfrew Hydro Inc. ("Renfrew Hydro") and my (our) financial institution to debit, in accordance with the Rules of the Canadian Payments Association, my (our) account at the branch specified in the Pre-Authorized Payment Plan Form which I (we) have completed, for the purpose of automatically paying my (our) monthly Renfrew Hydro statement of account, under the terms and conditions agreed to by me (us) with Renfrew Hydro until such time as written notice to the contrary is given by me (us) to Renfrew Hydro in accordance with the timing requirements listed below.

A debit may be drawn from my (our) account on the payment due date indicated on my (our) monthly statement of account. I (we) expressly waive any requirement of pre-notification of the amount and date of such debits. The amount and date of withdrawal of the debit may vary and the details will be identified on my (our) Renfrew Hydro bill every month.

I (we) will notify Renfrew Hydro in writing of any changes in my (our) banking and account information or my (our) intent to terminate this authorization at least thirty (30) days prior to the next date of the Pre-Authorized Payment Plan debit.

I (we) warrant and guarantee that: (1) the banking and account information provided is complete and accurate, and (2) all persons whose signatures are required to authorize withdrawals from the account specified have authorized the debits to be drawn from the specified account pursuant to this authorization. I (we) understand and accept the terms contained in this authorization, and further understand and agree that delivery of this authorization to Renfrew Hydro constitutes delivery by me (us) to the above-noted institution.

I (we) acknowledge and agree that except as otherwise explicitly provided in the present Terms and Conditions, nothing herein expands, limits or modifies the rights and obligations between myself (us) and Renfrew Hydro.

I (we) have certain recourse rights if any debit does not comply with this agreement. For example, I (we) have the right to receive reimbursement for any Pre-Authorized Payment Plan debit that is not authorized or is not consistent with this Pre-Authorized Payment Plan Form. To obtain a form for a Reimbursement Claim, or for more information on my (our) recourse rights, I (we) may contact my (our) financial institution or visit www.cdnpay.ca.

Renfrew Hydro reserves the rights to remove the account from the Pre-Authorized Payment Plan program when an account has two or more payments returned with nonsufficient funds in a 12 month period. In order for the account to be reinstated on the Pre-Authorized Payment Plan program, the account must not have incurred any additional nonsufficient fund charges for a 12 month period.

Renfrew Hydro reserves the right to withdraw this Pre-Authorized Payment Plan service (the “Service”) at any time upon reasonable notice. Renfrew Hydro may terminate my (our) use of the Service if I (we) have used the Services in any way that is contrary to law or in any way that disrupts the Service.

I (WE) CONFIRM AND ACKNOWLEDGE THAT USE OF THE SERVICE AND THIS WEB SITE CONSTITUTES KNOWLEDGE AND ACCEPTANCE OF ALL TERMS AND CONDITIONS.