Pre-Authorized Chequing Change Form

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PRE-AUTHORIZED CHEQUING
CHANGE REQUEST
Account Number:
Customer Name:
Service At:
Mailing Address:
same as above or:
City / Town:
Telephone: Home:
-
-
Postal Code:
Business:
-
-
ext
Email Address:
Enter in the effective date for the new banking information, please allow up to 14 days to process your request
Year
Month
Day
Yes  I have attached a “voided” cheque and hereby authorize my financial institution to debit my account in the name of
Alectra Utilities formerly known as PowerStream Inc.
Signature: ________________________________________________ Date: ____________________________
Fax the completed application and voided cheque to 1-877-236-6396 or mail with your next Alectra Utilities formerly known
as PowerStream payment.
Attach VOIDED CHEQUE here
TERMS AND CONDITIONS
Please allow up to 14 days to process your request
This agreement can be terminated, upon written notification (allow 14 days) at any time by either the customer or Alectra Utilities formerly known
as PowerStream.
Upon termination, ANY AMOUNT DUE shall be paid directly to Alectra Utilities formerly known as PowerStream. Cancellation of pre-authorized
debit (PAD) does not constitute cancellation of service by Alectra Utilities formerly known as PowerStream Inc. and the customer shall be liable
for any past, present or future amounts owing.
You have certain recourse rights if any debit does not comply with this agreement. For example, you 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 your recourse rights, contact your
financial institution or visit
Customer Service
1-877-963-6900 ~ 8:00 a.m. – 4:30 p.m. Monday to Friday or email
CustomerService@PowerStream.ca

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