Pre-authorized Payment Form

I (we) authorize Metropolitan Credit Adjusters Ltd. to process a debit, in paper, electronic or other form in the amount of
Please fill out the following information from your cheque:
A void cheque
I (We) acknowledge that I (we) must notify Metropolitan Credit Adjusters Ltd. a minimum of four business days prior to the payment date schedule above of any changes in account information and/or to stop the pre-authorized payment transaction. I (we) acknowledge that any changes occurred in failure to advise Metropolitan Credit Adjusters Ltd. of the above is my (our) responsibility. I (We) acknowledge that I (we) have read and understood all the provisions contained in the terms and conditions of the pre-authorized payment authorization.