ABYC Pre-Authorized Debit (PAD) |

About You

Name(Required)

First Last

ABYC Member Number (Primary)(Required)

Address(Required)

Street Address Address Line 2 City Province Postal Code

Primary Phone(Required)

Email(Required)

Financial Institution

Transit Number(Required)

Financial Institution Number(Required)

Account Number(Required)

Upload Void Cheque(Required)

This will be used to confirm the banking details you entered.

Max. file size: 32 MB.

Transactions Authorized by ABYC PAD

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Debit my bank account for the following Fees

Please select one option

Prorated Annual Dues, Storage Fees & Capital Assessments (with 12 equal debits on the 15th of each month)

Not Prorated Annual Dues, Storage Fees & Capital Assessments debit only the amount owed on the most recent invoice or statement on the 15th of each month)

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Other Charges

Please check all that apply

All Food & Beverage Charges (on the 15th of each following month)

Any Other Fees upon my/our written request sent to officeadministrator@abyc.ca

PAD Options(Required)

You may choose from three different PAD options. Please select one to automatically debit your bank account for the following:

For Senior and Life Members, prorated Annual Dues, Storage Fees and Capital Assessments (with 12 equal debits on the 15th of each month);
For Associates and Juniors, full payment of Dues and Fees on the 15th of the month after joining ABYC; and
All Food & Beverage and Clubhouse charges debited on the 15th of the month following when the charges were incurred. This includes all charges you may incur at ABYC.

For Senior and Life Members, prorated Annual Dues, Storage Fees and Capital Assessments (with 12 equal debits on the 15th of each month);
For Associates and Juniors, full payment of Dues and Fees on the 15th of the month after joining ABYC.
No debit for Food & Beverage and Clubhouse Charges (all Food & Beverage must be paid for by credit or debit card in the restaurant).

All Food & Beverage and Clubhouse charges debited on the 15th of the month following when the charges were incurred. This includes all charges you may incur at ABYC.
No debit for Annual Dues, Storage Fees and Capital Assessments.

Consent

Effective as of(Required)

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File

Max. file size: 32 MB.