Forms // EFT

Pre-Authorized EFT Enrollment

Payor Name *

Phone Number

Company Name *

Account # *

Enter your 9 digit TELAIR Customer Account Number.

Your Email *

Subject *

Institution # *

Transit # *

Account # *

I Agree *

I agree to participate in pre-authorized debit (PAD) with TELAIR. I am authorized to sign on behalf of the bank account holder (or am the account holder) indicated on this form. I acknowledge that my bank account indicted in this form will automatically be debited monthly for invoice amounts owing.

Separate email addresses with a comma.

Submit