Scribd
Upload
38 views1 page

Direct Deposit Enrollment Form 3

Uploaded by

seanMcQuoid
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
38 views1 page

Direct Deposit Enrollment Form 3

Uploaded by

seanMcQuoid
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 1

CONTRACT EMAILING & DIRECT DEPOSIT NOW AVAILABLE !

LAC now offers electronic delivery of your contracts, invoices as well as your settlements (if you enrolled in
direct deposit). For your convenience, we have included an enrollment form below that once completed, can
be emailed to [email protected]. Alternatively, please fax the completed form to our London office at
519-473-5781 or call us at 519-473-9333 or 1-800-265-1885. We appreciate your decision to market your
crops through LAC !

CONTRACT & INVOICE EMAILING ONLY OPTION: Please provide your email address. Contracts will be emailed to the
address provided below but payments will still be made to you by cheque

CUSTOMER NAME ________________________________________________________________


ADDRESS _______________________________________________________________________
EMAIL ADDRESS ___________________________________________

DIRECT DEPOSIT & CONTRACT EMAILING OPTION – You must provide an email address for us to set you up for this
service as copies of settlement information will NOT be mailed. Payments will be made directly to your bank account
and copies of settlements and contracts will be emailed to the address provided below.

LAC is pleased to be able to provide our customers the option of direct deposit for Canadian dollar settlements. If you are
interested in activating this service, please provide a void cheque and complete the information below. Missing or incomplete
information will delay the processing of your request. You can return the forms by fax to (519) 473-5781 or alternatively, your
application can be emailed directly to Debbie Johnson at [email protected].

Name on Account _________________________________________________ Bank Account #______________________

Customer Address_________________________________________________ Customer Phone #____________________

Beneficiary’s Bank_________________________________________________ Bank # ___________________________

Beneficiary Bank Address ___________________________________________ Transit # ___________________________

Email Address for remittance details(Mandatory) _______________________ Contact Name _______________________

I hereby authorize London Agricultural Commodities Inc. to initiate credit entries and (if necessary to correct transmission
errors) debit entries to the account at the depository named above. London Agricultural Commodities Inc. is not responsible for
payments that are deposited incorrectly based on incorrect information provided by you. Signature below also confirms that,
with respect to all grain sold by you to London Agricultural Commodities Inc., you have good title to such grain, free and clear of
all liens and encumbrances whatsoever.

This agreement is to remain in force and effect until one party has received written notification of termination from the other
party. If the party terminating the Agreement is not London Agricultural Commodities Inc., notice must be in such time and
manner to afford London Agricultural Commodities Inc. and the depository a reasonable opportunity to act on it. Either party
may terminate the Agreement for any reason at any time.

I understand London Agricultural Commodities Inc. must receive written notification before changes in the payment type will be
made.

Signature: ___________________________________________ Title : ____________________________

Name: ______________________________________________ Date: ____________________________

You might also like