Online form – Pre-authorized Payment Plan

Personal information

The address affected by this change:

Program terms and conditions

• The customer attests that the information on the authorization form is correct and that he/she will notify Enbridge Gaz Québec as soon as possible of any changes to the bank account;

• If there are not sufficient funds in the account or the amount required to pay the bill cannot be withdrawn, late payment charges will automatically be applied;

• The customer may cancel this authorization at no charge at any time. The customer is still required to pay any previous, current or future bills.

Authorization agreement for the pre-authorized payment plan

I (hereinafter referred to as “the customer”) accept the conditions stated herein and authorize Enbridge Gaz Québec and the financial institution named herein to make the monthly withdrawals required to pay my Enbridge Gaz Québec account. This authorization remains in effect until Enbridge Gaz Québec receives notification of cancellation from me giving it a reasonable period of time to cancel my membership in the Program, or until Enbridge Gaz Québec provides written confirmation of cancellation. The customer acknowledges receipt of the authorization and agrees to respect its terms and conditions.

I understand that my enrollment in the Pre-Authorized Payment plan will be effective as of my next invoice. My current charges if any, will have to be paid manually.

I understand that the personal information provided when filling out the online form is only used and necessary to receive Enbridge Gaz Québec’s services, to participate in the programs, or to respond to my enquiry, and in accordance to Enbridge Gaz Québec’s privacy policy.