Our Forms

Pre-Authorized Direct Debit (PAD) Agreement

I/We authorize Astro Guard Alarms, and the financial institution designated (or any other financial institution I/We may authorize at any time) to withdraw funds from my/our bank account.

This authority is to remain in effect until Astro Guard Alarms has received written notification from me/us of its change or termination.

Date:

Name(s):

Name on account (if different from above):

Type of Service: Alarm Monitoring

Address:

City:

Province:

Postal Code:

Phone Number:

Financial Institution:

Transit No.

Institution No.

Account No.

Please also attach a void cheque OR direct deposit slip from your bank if we do not already have one on file.

Amount:

Frequency: Monthly

Process Date: 1st of each month

Date:

Signature:

Cancellation Request Form

Account name:

Street Address:

City:

Province: BC

Postal Code:

Phone Number:

Please note we do require 30 days’ notice for cancellation as per your contract.

For further information see your contract for terms and conditions.

Today’s Date:

Cancellation Date:

Reason for cancellation:

Comments:

If you have equipment on loan, we will contact you to make arrangements for the return.

Signature:

Date:

Account Update Request Form

Account Name:

Premise Phone Number:

Address:

Emergency Contact Persons and Phone Numbers:

(This information is critical and will be used in the event of an emergency at your premises. Please ensure accuracy and list contacts in the order of which to call.)

Authorized Users and Password/Passcode:

(This information is to be confirmed with every update. Please fill this information out even if an update is not required.)

Name:

Date: