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  • 7/27/2019 Pre Authorized Payment

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    Copyright Envision Corporation. 2002. All rights reserved. Protected by the copyright laws of the United States & Canada and by nternational treaties. ! S""E#A" A$% S!C!"' P()*!E% !( %S!*U!E+ PU*"S)+ (,,E ,( SA"E+ "CE$SE ( SU*"CE$SE+ #-E ( %SC"(SE !( A$' (!)EPA!'+ !)S P(%UC! $ )A% C(P' ( %#!A" ,(. A"" (,,E$%ES /"" *E SUE% $ A C(U! (, "A/.

    Copyright Envision Corporation. 2002. All rights reserved. Protected by the copyright laws of the UnitedStates and Canada and by international treaties. ! S ""E#A" A$% S!C!"' P()*!E% !(%S!*U!E+ PU*"S)+ (,,E ,( SA"E+ "CE$SE ( SU*"CE$SE+ #-E ( %SC"(SE !(

    A$' (!)E PA!'+ !)S P(%UC! $ )A% C(P' ( %#!A" ,(. A"" (,,E$%ES /""

    AU!(A!CA""' *E SUE% $ A C(U! (, "A/. Copyright Envision Corporation. 2002. All rights reserved. Protected by the copyright laws of theUnited States & Canada and by international treaties. ! S ""E#A" A$% S!C!"' P()*!E% !(%S!*U!E+ PU*"S)+ (,,E ,( SA"E+ "CE$SE ( SU*"CE$SE+ #-E ( %SC"(SE !(

    A$' (!)E PA!'+ !)S P(%UC! $ )A% C(P' ( %#!A" ,(. A"" (,,E$%ES /"" *ESUE% $ A C(U! (, "A/.

    Copyright Envision Corporation. 2002. All rights reserved. Protected by the copyright laws of theUnited States & Canada and by international treaties. ! S ""E#A" A$% S!C!"' P()*!E% !(%S!*U!E+ PU*"S)+ (,,E ,( SA"E+ "CE$SE ( SU*"CE$SE+ #-E ( %SC"(SE !(

    A$' (!)E PA!'+ !)S P(%UC! $ )A% C(P' ( %#!A" ,(. A"" (,,E$%ES /"" *ESUE% $ A C(U! (, "A/.

    Copyright Envision Corporation. 2002. All rights reserved. Protected by the copyright laws of the UnitedStates and Canada and by international treaties. ! S ""E#A" A$% S!C!"' P()*!E% !(%S!*U!E+ PU*"S)+ (,,E ,( SA"E+ "CE$SE ( SU*"CE$SE+ #-E ( %SC"(SE !(

    A$' (!)E PA!'+ !)S P(%UC! $ )A% C(P' ( %#!A" ,(. A"" (,,E$%ES /""AU!(A!CA""' *E SUE% $ A C(U! (, "A/.

    February 27, 2014

    Contact $aeAddressAddress2City+ State1Provinceip1Postal Code

    OBJECT: PRE-AUTHORIZED PAYMENT, VARYING AMOUNT

    %ear 3C($!AC! $AE4+

    !his letter is to ac5nowledge that 3C(PA$'1$%-%UA"4 is hereby a6thori7ed to withdraw the ao6ntd6e on o6r 3$A!UE (, C)A#ES4 on a 3PE(% (, PA'E$!4 basis on the 3$U*E (, %A'S

    A,!E *""$# %A!E4 day after the billing date8

    *an58 3*A$9 $AE A$% A%%ESS4*an5 !ransit $o8 3*A$9 !A$S! $(.4

    Acco6nt $o8 3ACC(U$! $U*E4

    Company NameStreet+ City+ State1Province+ ip1Postal code !el8 :000; 000

  • 7/27/2019 Pre Authorized Payment

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    Copyright Envision Corporation. 2002. All rights reserved. Protected by the copyright laws of the United States & Canada and by nternational treaties. ! S""E#A" A$% S!C!"' P()*!E% !( %S!*U!E+ PU*"S)+ (,,E ,( SA"E+ "CE$SE ( SU*"CE$SE+ #-E ( %SC"(SE !( A$' (!)EPA!'+ !)S P(%UC! $ )A% C(P' ( %#!A" ,(. A"" (,,E$%ES /"" *E SUE% $ A C(U! (, "A/.

    *an5 !el. $o. 3*A$9 !E"EP)($E $U*E4*an5 Contact 3$AE (, *A$9 C($!AC! & !!"E4

    !his shall be yo6r good and s6fficient a6thority for so doing. /e enclose an 6nsigned chec5 fro theacco6nt ar5ed >-(%>.

    3$(!E8 , (E !)A$ ($E S#$A!UE S E?UE% ($ ACC(U$!+ A9E SUE *(!) *A$9S#$$# (,,CES S#$ "E!!E4

    Sincerely+

    'o6r nae

    'o6r title:@00; 2B