Payment Authorization Form

Payment Authorization Form

Authorization for Electronic Funds Transfer (EFT) for Rental Payments
Tenant Details
Name

First NameLast Name
Rental Address

Street Address

Apartment Number

CityState / Province
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Banking Details
Financial Institution Name:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Bank Code (3 Digits):
Transit Code (5 Digits):
Bank Account Number (7-11 Digits):
All rent payments are to be made by ETF (Electronic Fund Transfer) or direct debit. I/We agree to the terms and permit the debiting of our account for rent payments. Any information collected by Lowe Properties Ltd, for the purpose of providing the direct debit service will remain confidential and will only be disclosed to regulatory bodies with appropriate lawful authority. The direct debit authorization will remain in effect until written notice of cancellation is received by Lowe Properties Ltd. If you need to stop payment on a ETF for any reason we require 5 days written notice delivered to info@loweproperties.ca otherwise, if the debit is refused for any reason a $50.00 NSF fee will apply.
Do you read this Agreement and agree to the terms and conditions:
Signature
Copy of VOID Cheque or Direct Deposit Form
Should be Empty:

Tenant Details