Debit Pre-Authorization Form | Canada

Set up pre-authorized payments by direct debit from a customer's bank account with this Authorization Form, for Canadian merchants and financial institutions.

• The payments will be processed in accordance with the Rules of the Canadian Payments Association.
• This form can be used for regular payments on a mortgage or loan, insurance premiums, investments, pension plan contributions, or payments on a customer's account.
• The authorization can be revoked at any time, but the revocation does not alter the customer's obligations to make payments.
• Includes instructions for the procedure by which the customer can dispute a payment that has been improperly withdrawn.

Payments by pre-authorized debit are easier for both the customer and the creditor. Download the Authorization Form template for your customers.