{"id":4015,"date":"2018-08-24T15:01:16","date_gmt":"2018-08-24T19:01:16","guid":{"rendered":"https:\/\/www.groupesc.com\/?page_id=4015"},"modified":"2018-08-30T09:01:58","modified_gmt":"2018-08-30T13:01:58","slug":"pre-authorized-payment-form","status":"publish","type":"page","link":"https:\/\/www.groupesc.com\/en\/payment\/pre-authorized-payment\/pre-authorized-payment-form\/","title":{"rendered":"Pre-authorized Payment Form"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column]<div style=\"margin:;\" class=\"special-heading\">\n\t\t\t\t\t<h1 style=\"font-size:; font-weight:; line-height:; text-align:left; text-transform:none; color:;\">Pre-authorized Payment (PAP)<\/h1>\n\t\t\t\t\t<div style=\"background-color:; text-align:left;\" class=\"heading-seperator left-sep\"><\/div>\n\t\t\t\t\t<p style=\"font-size:; text-align:left; color:;\"><\/p>\n\t\t\t\t<\/div>[vc_column_text]<\/p>\n<h4>Use the following form to pay your debt by pre-authorized payment (PAP):<\/h4>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column]<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework paiementpreautorise_wrapper' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_5' ><div id='gf_5' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_5' id='gform_5' class='paiementpreautorise' action='\/en\/wp-json\/wp\/v2\/pages\/4015#gf_5' data-formid='5' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_5' class='gform_fields top_label form_sublabel_below description_above validation_below'><li id=\"field_5_32\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_32'>Name<\/label><div class='gfield_description' id='gfield_description_5_32'>This field is for validation purposes and should be left unchanged.<\/div><div class='ginput_container'><input name='input_32' id='input_5_32' type='text' value='' autocomplete='new-password'\/><\/div><\/li><li id=\"field_5_10\" class=\"gfield gfield--type-number gfield--input-type-number gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_10'>Amount ($ CAD)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_10' id='input_5_10' type='text' step='any' min='1'  value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_5_10\" \/><div class='gfield_description instruction ' id='gfield_instruction_5_10'>Please enter a number greater than or equal to <strong>1<\/strong>.<\/div><\/div><\/li><li id=\"field_5_12\" class=\"gfield gfield--type-select gfield--input-type-select gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_12'>Frequency<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_12' id='input_5_12' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>- select the payment frequency -<\/option><option value='Once only' >Once only<\/option><option value='Weekly' >Weekly<\/option><option value='Every two weeks' >Every two weeks<\/option><option value='Bimonthly' >Bimonthly<\/option><option value='Monthly' >Monthly<\/option><\/select><\/div><\/li><li id=\"field_5_30\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Date of the first payment<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div id='input_5_30' class='ginput_container ginput_complex gform-grid-row'><div class=\"clear-multi\">\n                                        <div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_5_30_2_container'>\n                                            <input type='number' maxlength='2' name='input_30[]' id='input_5_30_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_5_30_2' class='gform-field-label gform-field-label--type-sub '>DD<\/label>\n                                        <\/div><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_5_30_1_container'>\n                                        <input type='number' maxlength='2' name='input_30[]' id='input_5_30_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                        <label for='input_5_30_1' class='gform-field-label gform-field-label--type-sub '>MM<\/label>\n                                   <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_5_30_3_container'>\n                                        <input type='number' maxlength='4' name='input_30[]' id='input_5_30_3' value=''   aria-required='true'   placeholder='YYYY' min='1920' max='2027' step='1'\/>\n                                        <label for='input_5_30_3' class='gform-field-label gform-field-label--type-sub '>YYYY<\/label>\n                                   <\/div>\n                                <\/div><\/div><\/li><li id=\"field_5_5\" class=\"gfield gfield--type-textarea gfield--input-type-textarea commentaires field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_5'>Comment or other payment agreement (1000 characters maximum)<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_5' id='input_5_5' class='textarea medium'   maxlength='1000'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_5_8\" class=\"gfield gfield--type-section gfield--input-type-section gsection formpadtop field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Customer details<\/h2><\/li><li id=\"field_5_7\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_7'>Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_5_7' type='text' value='' class='medium' maxlength='250'    aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_13\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_13'>GSC account N\u2070<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_5_13' type='text' value='' class='medium' maxlength='250'    aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_14\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_14'>Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_5_14' type='text' value='' class='large' maxlength='250'    aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_18\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_18'>Telephone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_5_18' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_3\" class=\"gfield gfield--type-email gfield--input-type-email gf_right_half courriel field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_3'>Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_3' id='input_5_3' type='email' value='' class='medium'     aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_5_31\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><li id='field_3_19'  class='gfield gsection formpadtop field_sublabel_below field_description_above gfield_visibility_visible' ><h2 class='gsection_title'> Financial institution Information<a href=\"\/wp-content\/uploads\/2018\/09\/check-sample-en.png\" class=\"interrogation\" rel=\"slb\">?<\/a><\/h2><\/li><\/li><li id=\"field_5_21\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_21'>Account N\u2070<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_5_21' type='text' value='' class='medium' maxlength='250'    aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_22\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_22'>Transit N\u2070<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_5_22' type='text' value='' class='medium' maxlength='5'    aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_23\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_23'>Institution N\u2070<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_5_23' type='text' value='' class='medium' maxlength='3'    aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_28\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_28'>Account holder signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_28' id='input_5_28' type='text' value='' class='medium' maxlength='250'    aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_4\" 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id='live_validation_message_5_4'><\/div> <\/div><\/li><\/ul><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_5' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Send'  \/> <input type='hidden' name='gform_ajax' value='form_id=5&amp;title=&amp;description=&amp;tabindex=0&amp;theme=legacy&amp;styles=[]&amp;hash=54e5f6a4156f1f72bef3a0838bdb21a2' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_5' value='iframe' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_5' id='gform_theme_5' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_5' id='gform_style_settings_5' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_5' value='1' 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el_class=&#8221;autorisation&#8221;]<\/p>\n<p>By pressing send, I\/we authorize Groupe Solution Collect and the financial institution designated (or any other financial institution I\/We may authorize at any time) to begin deductions of the amount enter in the field \u00ab amount \u00bb for payment of all charges arising under my\/our account(s) with Groupe Solution Collect. Regular monthly payments for the full amount will be debited to my\/our specified account on the day of each month enter in the fill \u00ab date of first payment \u00bb . Groupe Solution Collect will obtain my\/our authorization for any other one-time or sporadic debits.<\/p>\n<p>This authority is to remain in effect until Groupe Solution Collect has received written notification from me\/us of its change or termination. This notification must be received at least ten(10) business days before the next debit is scheduled at our head-office. I\/We may obtain a sample cancellation form, or more information on my\/our right to cancel a PAP Agreement at my\/our financial institution or by visiting <a href=\"http:\/\/www.cdnpay.ca\" target=\"_blank\" rel=\"noopener\">www.cdnpay.ca<\/a>.<\/p>\n<p>Groupe Solution Collect may not assign this authorization, whether directly or indirectly, by operation of law, change of control or otherwise, without providing at least 10 days prior written notice to me\/us.<\/p>\n<p>\u00abI\/We have certain recourse rights if any debit does not comply with this agreement. For example, I\/We have the right to receive reimbursement for any PAP that is not authorized or is not consistent with this PAP agreement. To obtain a form for a Reimbursement Claim, or for more information on my\/our recourse rights, I\/We may contact my\/our financial institution or visit.<a href=\"http:\/\/www.cdnpay.ca\" target=\"_blank\" rel=\"noopener\">www.cdnpay.ca<\/a>\u00a0\u00bb[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column][vc_column_text] Use the following form to pay your debt by pre-authorized payment (PAP): [\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text el_class=&#8221;autorisation&#8221;] By pressing send, I\/we authorize Groupe Solution Collect and the financial institution designated (or any other financial institution I\/We may authorize at any time) to begin deductions of the amount enter in the field \u00ab [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":4012,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-4015","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.groupesc.com\/en\/wp-json\/wp\/v2\/pages\/4015","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.groupesc.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.groupesc.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.groupesc.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.groupesc.com\/en\/wp-json\/wp\/v2\/comments?post=4015"}],"version-history":[{"count":3,"href":"https:\/\/www.groupesc.com\/en\/wp-json\/wp\/v2\/pages\/4015\/revisions"}],"predecessor-version":[{"id":4232,"href":"https:\/\/www.groupesc.com\/en\/wp-json\/wp\/v2\/pages\/4015\/revisions\/4232"}],"up":[{"embeddable":true,"href":"https:\/\/www.groupesc.com\/en\/wp-json\/wp\/v2\/pages\/4012"}],"wp:attachment":[{"href":"https:\/\/www.groupesc.com\/en\/wp-json\/wp\/v2\/media?parent=4015"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}