AutoDebit: Enrollment Form

Enrollment in AutoDebit is optional. You are entitled by law to a copy of this authorization form, so please retain a completed copy for your records:

ONE - Enrollment Information

You will need to have this documentation to complete the enrollment process.

Bank Information Required:

Chequing Account

Savings Account with Chequing Privileges

Contact your bank/credit union for its "Routing #" and "Savings Account #".

STEP TWO - Complete Enrollment Form

Please enter the name and account number as shown on the Ford Credit Canada Limited ("Ford Credit") or Ford Credit Canada Leasing, a division of Canadian Road Leasing Company ("Ford Credit Canada Leasing") invoice.

Customer Name:

Account Number:

Bank Account Type (check one):

Chequing

Savings Account with Chequing Privileges

Bank/Credit Union Account Number:

Bank/Credit Union Routing Number:

Signature: _______________________ Date: __________

If the bank/credit union account is in a name other than yours, complete this section as well:

Bank/Credit Union Account Owner's Name:

Bank/Credit Union Account Owner's SIN:

Bank/Credit Union Account Owner's Signature:

_______________________ Date: __________

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I/We hereby request and authorize Ford Credit or Ford Credit Canada Leasing, as the case may be, to effect withdrawals from the chequing or savings account named above, as agreed between Ford Credit or Ford Credit Canada Leasing, as the case may be, and the bank/credit union identified above, or to draw by electronic funds transfer from the chequing or savings account named above, funds payable to Ford Credit or Ford Credit Canada Leasing, as the case may be. This authorization covers the schedule of payments or other amounts due as described in the contract identified above. This authorization may be cancelled at any time by Ford Credit, or Ford Credit Canada Leasing, as the case may be. I/We may cancel this authorization by written notice given to Ford Credit or Ford Credit Canada Leasing, as the case may be, said cancellation to be effective five (5) days after receipt of request.

STEP THREE - Print Enrollment Form

Choose the Print option from your browser's File menu to print the form. Make sure to retain a copy of your completed enrollment form for your records.

STEP FOUR - Send "Voided" Cheque with Form

If Chequing Account:
Please write "VOID" across a cheque from the bank/credit union account you specified above and attach the voided cheque to the completed authorization form. Information contained on the cheque will be used by Ford Credit and your bank/credit union to properly complete the enrollment process.

If Savings Account with Chequing Privileges:
Please write "VOID" across a cheque from the bank/credit union account you specified above and attach the voided cheque to the completed authorization form. Alternately you may provide your savings account number and routing numbers printed on bank/credit union letterhead. Information contained on this document will be used by Ford Credit and your bank/credit union to properly complete the enrollment process.

NOTE: We are not able to set up auto debit using a line of credit or a Visa cheque.

STEP FIVE - Mail Enrollment Form

Now, mail the completed and signed enrollment form along with a voided cheque/savings deposit slip to

Ford Credit Customer Service Centre
P. O. Box 2400
Edmonton, Alberta T5J 5C7

Allow approximately two (2) weeks for completion of the enrollment process. We'll notify you by mail of the date the automatic deduction will begin. Until then, please continue to make your regularly scheduled payments. If you have any questions about AutoDebit, Contact Us. You may also fax your information to 1-866-934-1705.