Winnipeg MB R3C 3M2
0000634
July 22, 2020
Account Number
QUOC P CHU XXX XXX 558
6 COPPERHILL CRT
HAMILTON ON L9C 0C2
Pre-authorized debit agreement confirmation
You have successfully created a pre-authorized debit agreement with the Canada Revenue Agency for
the following:
Payment allocation: Individual income tax (T1) - Tax amount owing
Creation date: 2020-07-22
First payment date: 2020-07-29
Frequency: One time
Number of payments: 1
Last payment date: 2020-07-29
Banking information: 02502 004 02506258483
Amount: $1,456.08
Important information about pre-authorized debit (PAD)
This pre-authorized debit agreement may not be considered as an established payment arrangement by
the Canada Revenue Agency. Any amount you owe is payable immediately upon (re)assessment. If
you have an established arrangement and want additional information, please call the Canada Revenue
Agency at 1-888-863-8657.
To cancel or modify your PAD agreement
If you would like to cancel or make changes to your PAD agreement yourself, you have to be
registered for My Account. This application is located on the Canada Revenue Agency website at
canada.ca/taxes where you select Log in/Register and follow the prompts. Your agreement(s) will be
located under the heading "Manage active agreement". Choose the agreement that you want to amend.
The modify and cancel options will then be available to use. Any changes made will require 5 business
days to take effect. You can also submit your request to the Canada Revenue Agency by fax at
204-983-0924, or mail it to:
Canada Revenue Agency
Revenue Processing Section - PAD unit
66 Stapon Road
Winnipeg MB R3C 3M2
Please note that changes sent to the Canada Revenue Agency by fax or mail may take up to 30 days to
take effect. If the Canada Revenue Agency does not receive your changes on time, you may be subject
to a fee if the financial institution is unable to process a debit according to your agreement with the
Canada Revenue Agency.
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To dispute a withdrawal
You have the right to receive a reimbursement for any payment that was not authorized by you as part
of your PAD agreement.
You can dispute any withdrawal from your bank account if:
- the payment was not withdrawn as you authorized; or
- the authorization was cancelled on time.
To be reimbursed for the disputed amount, you must contact your financial institution within 90 days
of the date on which the payment was debited from your bank account. You will be required to
complete a signed declaration stating that one of the above situations took place. If it is after the
90-day period, you must contact the Canada Revenue Agency directly to dispute the withdrawal.
To obtain more information on your rights to cancel your PAD agreement or on your recourse
rights, contact your financial institution or visit payments.ca.
Terms and conditions of authorization to the Canada Revenue Agency
You understand and agree that the payment authorization is provided as a convenience to you and that
set-up or cancellation of the authorization shall not cancel or have any other effect on the underlying
obligation that you have under the Income Tax Act or any other Act of Parliament.
You agree to participate in this PAD agreement for personal PAD purposes.
You authorize the Canada Revenue Agency to automatically withdraw funds from your bank account
for payment of your tax obligation in accordance with the amount and time intervals that you provided
and as noted in this letter. The authorization will remain in effect unless it is cancelled or expires. You
may cancel the authorization at any time online up to 5 business days prior to the next withdrawal
date. The Canada Revenue Agency may also cancel this agreement if a payment is dishonoured by
your financial institution for any reason.
You certify that the financial institution information provided is accurate. You agree to update your
agreement information in a timely manner. You acknowledge that your financial institution is not
required to verify any information contained in your authorization.
You guarantee that you have full authority for completing a PAD from the bank account provided.
You consent to the disclosure of any information to the financial institution that is contained in the
authorization to process the payments as directed by you.
A completed PAD authorization to the Canada Revenue Agency becomes a completed authorization to
the financial institution you have indicated.
You waive your right to receive pre-notification of the amount of the PAD and agree that you do
not require advance notice of the amount before the payment is processed.
Keep this document for your records.
Thank you for choosing a pre-authorized debit agreement.
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