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Pre-Authorized Debit Cancel Form

Ghesi Forms Pre-Authorized Debit Cancellation Form

For existing Guelph Hydro account holders who would like to cancel their pre-authorized debit plan.

Fields marked with an asterisk(*) must be completed

Step 1 - Current Guelph Hydro Account Holder Information

Guelph Hydro Account Holder Information
 
 
 

Step 2 - Current Service Profile Information

Service Profile Information
Service address under the contract for which you are the account holder.
My Mailing address is the same as my new service address?

Step 3 - Submit My Request

By providing Guelph Hydro Electric Systems Inc. with personal information as set out in this document, I hereby consent to the collection, retention and use of this information by Guelph Hydro Electric Systems Inc. in accordance with its privacy policy, which is available at www.guelphhydro.com

1) Definitions
 a)“I”, “me”,“we”, “us”, “my”, “our” refers to each holder of the PAD agreement
 b) “you” and “your” refers to Guelph Hydro Electric Systems Inc. (GUELPH HYDRO)

2) Acknowledgements
 a) By signing below, I/we authorize GUELPH HYDRO to debit the aforementioned PAD account set out above for the purpose of payment of all charges arising under my/our GUELPH HYDRO account for all amounts owed to you by us from time to time and, in the event this is a change to an existing authorization agreement, to cease debiting the PAD account we previously established for this purpose
 b) This authorization will remain in effect until GUELPH HYDRO has received written notification of its change or termination (see cancellation rights below)
 c) By confirming below, I/we acknowledge that cancellation of the pre-authorized payment plan does not relieve me/us of any obligation to pay all amounts owing to GUELPH HYDRO. Cancellation of the pre-authorized payment plan does not constitute cancellation of services with GUELPH HYDRO and I/we shall be liable for any past, present or future amounts owing. For information about how to cancel your GUELPH HYDRO account, please visit the Guelph Hydro Website.
 d) By confirming below I/we acknowledge that the amounts to be drawn against our PAD account may vary in accordance with amounts billed to us by GUELPH HYDRO and that in the case of equal payment plans may include periodic and/ or annual adjustments and we authorize GUELPH HYDRO to draw such amounts without any pre-notice or other consent by us. For information about equal payment plans, please visit www.guelphhydro.com
 e) I/we acknowledge that cancellation of pre-authorized payment under an equal payment plan constitutes termination of the equal payment plan and all monies owed become due and payable upon cancellation
 f) In the event of any pre-authorized debit being returned for any reason (including insufficient funds), the account holder shall be obligated to pay GUELPH HYDRO an NSF fee and GUELPH HYDRO reserves the right to remove any customer from this plan for returned payments
 g) GUELPH HYDRO endeavours to process payment within three (3) business days of the due date/equal payment plan date, however, there can be no guarantee of the date payment will be processed

3) Accuracy
 a) I/we warrant on a continuing basis that all persons whose signatures are required to deal with the PAD account have signed this PAD authorization and that the information set out above is accurate and complete
 b) I/we will notify you in writing (by completing a new PAD authorization) of any changes at least ten (10) business days prior to the next scheduled debit

4) Cancellation Rights
 a) I/we have the right to cancel this agreement at any time, by giving you at least ten (10) business days written notice
 b) I/we may cancel our account by submitting an updated PAD agreement. Alternatively, I/we may obtain a sample cancellation form or further information regarding my/our right to cancel a PAD agreement at my/our financial institution or by visiting the Canadian Payment Association

5) Recourse Rights
 a) 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 PAD that is not authorized or consistent with this PAD agreement. To obtain a form for reimbursement claim, or for more information on my/our recourse rights, I/we may contact my/our financial institution or visit the Canadian Payment Association

I/we confirm to you that I/we have read, understand and agree to the Terms and Conditions of this PAD cancellation Agreement. I/We herby waive any requirement for pre-notificaiton of changes in the amounts and/or payment dates of PADs drawn against my/our account at my/our financial institution in accordance with this authorization.

Guelph Hydro Electric Systems Inc. uses the information collected on this form only to facilitate pre-authorized payment for services. We are committed to protect your personal information in compliance with the Personal Information Protection and Electronic Documents Act. For more information about Guelph Hydro's commitment to privacy, please visit the Guelph Hydro Website.