Pre-Authorized Payment Plan   B E T W E E N   1. Burlington Network Services 1376 Plains Rd E. Burlington, Ontario L7R 3P8 Toll Free: 1-800-263-8433 Fax #: 905-632-3536   A N D   2. The Customer   Corporate Name (if applicable)   Address   City   Province   Postal Code   Telephone No.   Fax No.     The customer authorizes BNS to draw pre-payment for Internet service package by: monthly debit from chequing account (void cheque must be attached). monthly billing to credit card     Visa:    MasterCard:    American Express:     Card No.   Name on Card   Expiry Date   Signature     All automatic, pre-authorized payments will be submitted to the client's financial institution on the 1st day of any month. BNS requires minimum 3 business days notice to suspend any pre-authorized payment.