OFC COMMUNITY KEEPERS INVESTMENT GROUP INC. Pre-Authorized Debits (PAD) Form Please complete the Pre-Authorized Debit (PAD) Plan Agreement below
I/we authorized OFC COMMUNITY KEEPERS INVESTMENT GROUP INC. and the financial institution designated (CIBC) (or any other financial institution I/We may authorize at any time) to begin deductions as per my/our instructions for monthly/annually regular recurring payments and/or one-time payments from time to time, for payment of all charges arising under my/our OFC COMMUNITY KEEPERS INVESTMENT GROUP INC. account. Regular monthly payments for the full amount of service delivered will be debited to my/our account specified on the 20th of each month. OFC COMMUNITY KEEPERS INVESTMENT GROUP INC. will obtain my/our authorization for any other one-time or sporadic debits.
This authority is to remain in effect until OFC COMMUNITY KEEPERS INVESTMENT GROUP INC. has received written notification from me/us of its change or termination. This notification must be received at least ten (10) business days before the next debit is scheduled at the address provided below. I/We may obtain a sample cancellation form, or more information on my/our right to cancel a PAD Agreement at my financial institution or by visiting www.OFCCOMMUNITY.com
OFC COMMUNITY KEEPERS INVESTMENT GROUP INC. may not assign this authorization, whether directly or indirectly, by operation of law, change of control or otherwise, without providing at least 10 days prior written notice to me/us.
I/We have certain recourse rights if any debit does not comply with this agreement. For example, I/We have the right to receive reimbursement for any PAD that is not authorized or is not consistent with this PAD Agreement. To obtain a form for a Reimbursement Claim, or for more information on my/our recourse rights, I /We may contact my/our financial institution or visit www.cdnpay.ca
Your First Name (required)
Your Last Name (required)
Type of Contribution (required):
ONYX $500/ Month or $6000/ YearDIAMOND $100/ Month or $1200/year (Check box below)PLATINUM $15.00/Month or $180.00/Year (10% discount for 1 time payment)GOLD $10.00/Month or $108.00/Year (10% discount for 1 time payment)SILVER $15.00/Month or $180.00/Year (10% discount for 1 time payment)BRONZE $20.00 One time contribution
Investment Contribution (If applicable) :
Monthly ($100/ Month)Quarterly ($300 Every: January, April, July, & October)Bi-Annually: ($600 Twice January & June)Annually: ($1200/ One time payment January)
Your Email (required)
Payments are withdrawn on the 20th of every month
Authorized Signature (Sign below using your mouse)
upload voided check
OFC COMMUNITY KEEPERS INVESTMENT GROUP Inc 5015 Maurice, St-Hubert, QC, J3Y 2N3 | 514-651-4545 | OFCCOMMUNITY.COM | ONEFULLCIRCLE@OFCCOMMUNITY.COM