At your service
24 hours a day
seven days a week
Thank you for your interest in the MBNA Canada Electronic Debit Service. To set up
electronic debits, we must have your signature on file and you must register. Please
follow the instructions below so we can register you for this program upon approval of
your application for an MBNA Canada Personal Line account:
1. Please complete and sign where indicated below and attach a VOID cheque from
your personal chequing account. Should you not have a cheque, please obtain a letter
from your financial institution, signed by a representative from such financial
institution. This letter must include the Bank ID Number, the Transit Number, and the
Account Number.
2. Return the completed, signed form by fax to 1-877-813-6402, or
by mail to MBNA Canada:
Electronic Debit Service
P.O. Box 9625
Ottawa, Ontario
K1G 6T5
If you have any questions, please call 1-888-876-6262, or write to P.O. Box 9614, Station T, Ottawa,
Ontario, K1G 6E6. We are at your service 24 hours a day, 7 days a week.
AUTHORIZATION
I/We, applicant(s) for the MBNA Canada Personal Line (“Personal Line”), authorize MBNA
Canada (“MBNA”) to debit my/our bank account for the purpose of paying my/our Personal Line.
I/We agree that you are authorized to debit my bank account each month: 1) for the minimum
monthly payment amount set out in each monthly Personal Line statement of account and; 2) on
the payment due date set out in each monthly Personal Line statement of account. Additional
debit(s) may be processed at such time(s) as I/we may authorize. I/We warrant and guarantee that
I/we have provided MBNA with the relevant information in respect of the bank account and that
all persons required to sign on the bank account have signed this Authorization. This
Authorization may be revoked on 30 days’ notice to MBNA.
Name of Bank: _______________________________________________________________
Transit Number: ______________________________________________________________
Personal Chequing Account Number: ________________________________________________
Application Reference Number: ____________________________________________________
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Please credit my electronic payments to my MBNA Personal Line account, which is currently
being processed.
If you have any questions, please call 1-888-876-6262. We are at your service 24 hours a day,
seven days a week.
To also authorize electronic payments for MBNA Canada credit card accounts (upon further
specific instructions), please list the 16-digit card number for each credit card account below:
MBNA Canada Credit Card Account Number: ______________________________________
Additional MBNA Canada Credit Card Account Number: _____________________________
______________________________________
Name of MBNA Canada Personal Line Applicant
___________________________________ _______________________________________
Chequing Account Holder’s Full Name Chequing Account Holder’s Signature
(Please print your name as it appears on your bank statements.)
___________________________________ _______________________________________
Additional Required Signatory’s Full Name Additional Required Signatory’s Signature
(If applicable.) (If applicable.)
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