Pre-authorized Debit Agreement Logo
  • Pre-authorized Debit Agreement

    Monthly Donations Agreement – Bank Account Withdrawals
  • Note: This form uses Secure Sockets Layer (SSL) technology for both server authentication and data encryption, helping to ensure that your data is safe and secure.

    We do not collect personal information from individuals unless they provide it voluntarily and knowingly. We will use the information only for the purposes of providing the requested services or information. We will only contact you with regards to the interests and information you have requested.

  • Donor Information

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  • Donor Bank Account Information (“Account”) & Payment Details

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  • Regular monthly donation amounts will be debited from my/our specified Account between the 11th and the 14th of each month.

  • Pre-Authorized Debit Terms

  • Authorization: I/We acknowledge that this PAD Agreement is provided for the benefit of Communitas Supportive Care Society, as the payee, and is provided in consideration of Vancouver City Savings Credit Union agreeing to process debits against the Account (designated above) with my/our financial institution (or any other financial institution I/we may authorize at any time) in accordance with CPA rules. 

    I/we confirm that we have authority under the terms of my/our Account agreement to authorize this debit arrangement. 

    By signing this PAD Agreement, I/we acknowledge having received and read a copy of this PAD Agreement, including the terms contained herein; I/we acknowledge that I/we understand the terms of this PAD Agreement; and I/we agree to be bound by the terms of this PAD Agreement.  

    I/we authorize at any time in the Transaction Date period indicated above, for PADs to be drawn on my/our Account according to this PAD Agreement.

    I/We warrant and guarantee that the person(s) whose signature(s) are required to sign on the Account have signed this PAD Agreement.

    Confirmation and Pre-notifications: Communitas Supportive Care Society will, at least 10 calendar days before the due date of the first PAD, provide me/us a confirmation in accordance with Rule H1. 

    For fixed-amount, set interval PADs (e.g., monthly PADs) Communitas Supportive Care Society, will provide me/us with 10 days’ prior written notice specifying the amount and date of the next PAD before any changes are made to the fixed amount PAD and of any change to the scheduled payment date(s), unless an exception under Rule H1 applies. 

    Cancellation of PAD Agreement: I/we acknowledge that I/we may revoke, change or cancel my/our authorization under this PAD Agreement at any time in writing to Communitas Supportive Care Society. I/we understand and accept that this notification must be provided to Communitas Supportive Care Society at the contact information indicated below at least 30 calendar days before the next debit is scheduled. 

    Upon providing a notice of cancellation or revocation of authority, Communitas Supportive Case Society will cease issuing in accordance with Rule H1. 

    To obtain a sample cancellation form, or for more information about my/our right to cancel this PAD Agreement, I/we acknowledge that I/we can contact my/our financial institution or visit www.payments.ca. 

    Recourse/Reimbursement: I/we acknowledge that 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 debit that is not authorized or is not consistent with this PAD Agreement. To obtain more information on my/our recourse rights, I/we may contact my/our financial institution or visit www.payments.ca. 

  • Payee Contact Information

  • Payee Name:
    Communitas Supportive Care Society

    Charitable Registration No. 134106228RR0001

    Address:
    103 – 2776 Bourquin Crescent, Abbotsford, BC V2S 6A4

    Telephone/Email:
    604-850-6608 |  Philanthropy@communitascare.com

  • Donor Agreement Section

  • I/We understand and accept the terms of entering into this PAD Agreement and participating in this PAD plan.

  • Use your mouse to draw your signature on desktop or use your finger to draw if on your mobile phone.

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  • Note: If only one (1) signature is required for the Payor Account, then only 1 Payor signature is required to sign this PAD Agreement. If two (2) or more signatures are required for the Payor Account, then both or all Payors must sign this PAD Agreement.

  • Once you hit the Submit button below, your authorisation will be emailed to Communitas. A PDF copy of your Agreement will be emailed to you.

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