pre-authorized payment plan agreement - volkswagenpre-authorized payment plan agreement in this...

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Pre-authorized Payment Plan Agreement In this Agreement, words in the plural include the singular FRANÇAIS AU VERSO 76-302-5635 (05/11) E/F Option # 1 - Payment by Account Holder We, the undersigned, hereby authorize VW Credit Canada, Inc. and the financial institution designated (or any other financial institution we may authorize at any time) to withdraw from our bank account our monthly payment under the terms of a Contract of Sale by Installment or Lease Agreement executed by us, as per the schedule on such contract or following a mutual agreement. We confirm that we have read this document in its entirety before signing it. 1) 2) (Signature of Account Holder or Signing Officer) (Signature of Account Holder or Signing Officer) Option # 2 - Payment by third party We, the undersigned, hereby authorize VW Credit Canada, Inc. and the financial institution designated (or any other financial institution we may authorize at any time) to withdraw from our bank account our monthly payment under the terms of a Contract of Sale by Installment or Lease Agreement, as per the schedule on such contract or following a mutual agreement under the name of: 2) (VW Credit Canada, Inc. Customer Signature) Relationship with Customer VW Credit Canada, Inc. reserves the right to accept or refuse this Authorization if it considers the relationship not pertinent to the customer. This Authorization does not give any rights to the third party under the terms of the Contract of Sale by Installment or Lease Agreement. This authorization remains in effect until VW Credit Canada, Inc. has received written notification from us of a change or termination. This notification must be received, at the address below, at least ten (10) business days before the next payment is scheduled. We may obtain a Cancellation Form or more information on our right to cancel a Pre-authorized Payment Agreement at our financial institution or by visiting www .cdnpay .ca. We acknowledge and agree to a second presentation in the case of payments not honoured by our financial institution. We have certain recourse rights if any payment does not comply with this Agreement. For example, we have the right to receive reimbursement for any pre-authorized payment that is not authorized or is not consistent with this Pre- authorized Agreement. To obtain a form for a Reimbursement Claim or for more information on our recourse rights, we may contact our financial institution or visit www .cdnpay .ca. These services are for (check one): PLEASE ATTACH THE VOID CHEQUE WITH ADHESIVE TAPE. PLEASE WRITE THE MENTION “VOID” ON THE CHEQUE. IMPORT ANT Credit line and credit card void cheques are not accepted. The void cheque must clearly indicate the names and addresses of the customer and the financial institution. 1) Branch number: (5 digits) 2) Bank number: (3 digits) 3) Bank account number: VOLKSWAGEN FINANCE IS A DIVISION OF VW CREDIT CANADA, INC. Customer Name: Date: Account # with VW Credit Canada, Inc. or Vehicle Identification Number: VW Credit Canada, Inc. Customer Name 1) (Signature of Account Holder or Signing Officer) We confirm that we have read this document in its entirety before signing it. Address: VW Credit Canada, Inc. 300 - 4865 Marc-Blain St., Saint-Laurent, QC H4R 3B2 Phone: (800) 668-8224 Personal Use Business Use 12345123 123123123 Branch # Bank # Bank Account # 1 2 3

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Page 1: Pre-authorized Payment Plan Agreement - VolkswagenPre-authorized Payment Plan Agreement In this Agreement, words in the plural include the singular 76-302-5635 (05/11) E/F FRANÇAIS

Pre-authorized Payment Plan AgreementIn this Agreement, words in the plural include the singular

FRANÇAIS AU VERSO76-302-5635 (05/11) E/F

Option # 1 - Payment by Account Holder

We, the undersigned, hereby authorize VW Credit Canada, Inc. and the financial institution designated (or any otherfinancial institution we may authorize at any time) to withdraw from our bank account our monthly payment under theterms of a Contract of Sale by Installment or Lease Agreement executed by us, as per the schedule on such contractor following a mutual agreement. We confirm that we have read this document in its entirety before signing it.

1) 2)(Signature of Account Holder or Signing Officer) (Signature of Account Holder or Signing Officer)

Option # 2 - Payment by third party

We, the undersigned, hereby authorize VW Credit Canada, Inc. and the financial institution designated (or any otherfinancial institution we may authorize at any time) to withdraw from our bank account our monthly payment under theterms of a Contract of Sale by Installment or Lease Agreement, as per the schedule on such contract or following amutual agreement under the name of:

2)(VW Credit Canada, Inc. Customer Signature)

Relationship with Customer

VW Credit Canada, Inc. reserves the right to accept or refuse this Authorization if it considers the relationship notpertinent to the customer. This Authorization does not give any rights to the third party under the terms of theContract of Sale by Installment or Lease Agreement.

This authorization remains in effect until VW Credit Canada, Inc. has received written notification from us of a changeor termination. This notification must be received, at the address below, at least ten (10) business days before the nextpayment is scheduled. We may obtain a Cancellation Form or more information on our right to cancel a Pre-authorizedPayment Agreement at our financial institution or by visiting www.cdnpay.ca.

We acknowledge and agree to a second presentation in the case of payments not honoured by our financialinstitution.

We have certain recourse rights if any payment does not comply with this Agreement. For example, we have the rightto receive reimbursement for any pre-authorized payment that is not authorized or is not consistent with this Pre-authorized Agreement. To obtain a form for a Reimbursement Claim or for more information on our recourse rights, wemay contact our financial institution or visit www.cdnpay.ca.

These services are for (check one):

PLEASE ATTACH THE VOID CHEQUE WITH ADHESIVE TAPE.PLEASE WRITE THE MENTION “VOID” ON THE CHEQUE.

IMPORTANTCredit line and credit card void cheques are not accepted.

The void cheque must clearly indicate the names and addresses of the customer and the financial institution.

1) Branch number: (5 digits)

2) Bank number: (3 digits)

3) Bank account number:

VOLKSWAGEN FINANCE IS A DIVISION OF VW CREDIT CANADA, INC.

Customer Name: Date:

Account # with VW Credit Canada, Inc. or Vehicle Identification Number:

VW Credit Canada, Inc. Customer Name

1)(Signature of Account Holder or Signing Officer)

We confirm that we have read this document in its entirety before signing it.

Address: VW Credit Canada, Inc. 300 - 4865 Marc-Blain St., Saint-Laurent, QC H4R 3B2 Phone: (800) 668-8224

Personal Use Business Use

�12345�123� 123�123�123

Branch # Bank # Bank Account #1 2 3