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   11 Crestview Place

   Unit 1

   Kitchener, ON

   N2B 3X6

   Tel: 519-893-4411

   Fax: 519-584-2277

Unit Profile Form

Pre-Authorized Payment Form


Below is the pre-authorized payment (P.A.P) form that is required to ensure your condominium fees will be paid to the :

condo corp. account. Please complete this form to set up your account on the pre-authorized payment system.

I/We authorize Condo Corp.:

by its agent Weigel Property Management Ltd., to access my/our bank account for the purpose of the monthly common element fee payment for my unit(s). Payments will be made in the amount of :

on the first day of the month or the first banking day of the month. For this purpose, I/We have provided the pertinent bank information below.

mm/dd/yyyy -- PAD Start Date

Bank Account Information :

Please complete your bank information below, all three sections must be completed.
Cheque Example-- Account Info

Financial Institution :

These services are for :

Personal

Business

You, the Payor, may revoke your authorization at any time in writing subject to providing 30 days notice. To obtain a sample cancellation form or for more information on your right to cancel a PAD Agreement, contact your financial institutions or visit www.cdnpay.ca

999-999-9999

You have certain rights if any debit does not comply with this agreement. For example, you 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 your recourse rights, contact your financial institution or visit www.cdnpay.ca

By checking this box I authorize this as my electronic signature