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Submission information
Form:
9. Pre-Authorized Debit (PAD) Plan agreement
Submitted by
Ekaterina Azarova
Sat, 04/15/2023 - 23:07
142.134.26.225
Name(s)
Vitalii Azarov
Date
Sat, 04/15/2023
Address*
222 Churchill Downs Circle
City*
Halifax
Province
Nova Scotia
Postal Code*
B4E2j7
Phone (Bus.)
7822349112
Phone (Res.)
Phone (Cell)
Name and Branch*
RBC bank
FI Account Number*
5451810
FI Transit Number (branch – 5 digits; FI – 3 digits)*
05783003
Account Type
Chequing
Branch Address*
271 Lacewood Dr
City*
Halifax
Province*
Nova Scotia
Postal Code*
b3m4k3
Authorized Signature(s)*
Vitalii Azarov
Sat, 04/15/2023 - 23:05
Email Address*
Vit.azarov@gmail.com
Child(ren)’s Name(s):
Alisa
Please upload a copy of a VOIDED cheque on the above named account.
View and Print Void Cheque - RBC Online Banking.pdf
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