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Letter to Disable Automatic Billing - Template Form Pro · EN-CA-law

✓ Valid in Canada (English) · drafted to comply with local law

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Letter to Disable Automatic Billing - Template Form
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NOTICE OF REVOCATION OF PRE-AUTHORIZED DEBIT AUTHORIZATION AND CANCELLATION OF ACCOUNT

________
________
Telephone: ________
Email: ________

Date: ________

DELIVERED BY: ________

________
Attention: ________
________

RE: Revocation of Pre-Authorized Debit (PAD) Authorization and Cancellation of Account No. ________

Dear Sir or Madam:

§ 1. Purpose of this Notice. I am writing to revoke, with immediate effect, the authorization previously granted to ________ (the “Company”) to debit my account by way of pre-authorized debit, automatic withdrawal, or recurring charge, and to cancel my account with the Company. This Notice constitutes formal revocation of that authorization in accordance with the Canadian Payments Association (Payments Canada) Rule H1 governing pre-authorized debits and any applicable terms of my agreement with the Company.

§ 2. Account Identification. My account number with the Company is ________. The pre-authorized debits are charged to the following payment instrument or financial account: ________, held at ________.

§ 3. Particulars of the Recurring Charge. On a ________ basis, the amount of $________ (________ dollars) is automatically withdrawn from the account identified above.

§ 5. Cancellation of Account. I further request that my account with the Company, identified in § 2 above, be cancelled and that all recurring services associated with it be terminated as at ________.

§ 6. Final Permitted Withdrawal. I understand and expect that the final automatic withdrawal will occur on ________. No further withdrawals are authorized after that date.

§ 8. Confirmation Requested. Kindly confirm in writing, within ________ days of receipt of this Notice, that: (a) this Notice has been received; (b) the pre-authorized debit authorization has been cancelled; and (c) my account has been closed and no further amounts are or will be owing. Such confirmation may be sent to me at the address or email set out above.

§ 9. Outstanding Balances. Nothing in this Notice shall be construed as a waiver or acknowledgement of any amount alleged to be owing. Any statement of a final balance, if any, should be provided to me in writing together with the supporting particulars.

§ 10. Contact. Should you require any additional information to process this cancellation, please contact me using the particulars set out at the top of this letter.

Yours truly,

________
Signature: ________
Date: ________

cc (copy for your records): ________

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