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| Pre-Authorised Payment |
If you currently have an account with Echo Online Internet Inc., and would like to use PAP (Pre-Authorised Payments) to maintain your account, print and fill out this form, then mail it to Echo Online Internet Inc. at 2600 Skymark Ave, Building 9 Suite 201, Mississauga, Ontario L4W 5B2 or optionally fax it to us at 416-385-0469.
Name:______________________________________________________
Address:__________________________________________________
City:________________________ Province:____________________
Postal Code:______________________
Phone Number:________________ Fax Number:__________________
User Name (email/shell login):________________________________________
I (we) authorize Echo Online Internet Inc. to process a monthly debit, in
paper, electronically, or any other form on my bank account in the amount
necessary to render my account with Echo Online Internet Inc. to a
positive balance.
I (we) understand that written notice must be received by Echo
Online Internet Inc. in order to terminate this agreement.
I (we) warrant that all persons whose signatures are requested to sign on
this account have signed and received a copy of this agreement.
Date:______________ Signature: x_____________________________________
Print Name:____________________________________________________
(If your account requires two signatures for authorisation)
Date:______________ Signature: x_____________________________________
Print Name:____________________________________________________
Mail this completed form along with a voided check to:
Echo Online Internet Inc. at
2600 Skymark Ave, Building 9 Suite 201, Mississauga, Ontario L4W 5B2 or
Fax this completed form and a voided cheque to: 416-385-0469