Pre-Authorized Payment Form

Account Information

Case Number*

Name*

Phone*

Address*

Email*

I (we) authorize MetCredit (Metropolitan Credit Adjusters Ltd). to process a debit, in paper, electronic or other form with the following details:

Amount*

Withdrawal date(s)*

Bank or Financial Institution*

Beginning date*(payment will be loaded in 2 days)

Ending date*

When the account is paid in fullDate below:

Please fill out the following information from your cheque:

Institution (Bank) Number (3 digits)*

Transit Number (5 digits)*

Account Number (7-12 digits)*

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.

Thank you!

Your request has been received, please allow 2 business days to load the account, if your payment is due before then, please call 1 888 797 7727 or contact.

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