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Tenant’s Authorization

TENANT’S AUTHORIZATION FOR PREAUTHORIZED DEBITS FOR TENANCY PURPOSES

Building/Address*
Building/Address Tenants Name and Address of Rental Property please print
I/We warrant and represent that the following information is ccurate.
Tenants Name*
Prefix First Last Suffix
Address*
Street Address City Province Postal Code
Telephone Number*
Your Email*

Please enter your email address. We will send you the confirmation of the receipt.
Start Date*
Date Format: MM slash DD slash YYYY
BANK INFORMATION
Please fill out information as they appear on your cheque) The name on cheque must match name(s) of the tenant(s) on our records. (Please attach, or email us a void cheque to info@bolld.ca for confirmation of details)
Bank’s Name*
Bank’s Full Address
Street Address Address Line 2 City Province Postal Code
Account Holder's Name*
Please enter the account holder's name, exactly as it appears on your cheque.
Authorized Amount*
Please enter the authorized amount. It should be the amount of total rent. This is the amount that will be debited from your account.
Institution Number (3 digits)*
Transit Number (5 Digits)*
Account Number (7 - 15 digits)*
Upload a picture of a VOID Cheque
In order to make sure the provided bank information is correct. Please upload a picture of a VOID cheque.
Please fill out below information if the payer is person other than yourself.
Account Holder’s Name
Relation to Applicant
Contact Phone Number
Or, If your account does not provide cheques, please include a document filled out by your bank to ensure the account is coded correctly and will allow for preauthorized payment
TERMS & CONDITIONS
1. I/We hereby authorize Bolld Enterprises Inc. on behalf of the owner of the rental property to deduct for the following:
  - Regular recurring monthly rent payments on the 1st of each month
  - Onetime payment for charges/debits arising under my/our Tenancy Agreement
  - Bolld Enterprises Inc. will obtain my/our authorization for any other onetime or sporadic debits including but not limited to; move in or move out fees, NSF & Late fees, Strata Fines and Rental Increases
2. I/We will inform the Bolld Enterprises Inc, in writing, of any change in the information provided in this section of the Authorization 10 days before the next due date of the PAD.
3. This authority is to remain in effect until Bolld Enterprises 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/our financial institution or by visiting www.cdnpay.ca
4. Bolld Enterprises 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.
5. I/We have certain recourse rights if any debit does not comply with this agreement. For example, I 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
AUTHORIZATION
Print Client Name*
Print Client Name
Authorized Signature*
Authorized Signature
Date*
Date Format: MM slash DD slash YYYY

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