ACH Authorization Form

Please fill out the following form to apply for automatic payments. The security of your personal information is important to us. All sensitive data is protected with encryption and stored temporarily. For more information about privacy, please visit our privacy policy page.

I (we) hereby authorize No Frills Oil to initiate entries to my (our) checking/savings accounts at the
financial institution listed below (THE FINANCIAL INSTITUTION), and, if necessary, initiate
adjustments for any transactions credited/debited in error. This authority will remain in effect until
No Frills Oil is notified by me (us) in writing to cancel it in such time as to afford No Frills Oil and THE
FINANCIAL INSTITUTION a reasonable opportunity to act on it.

* A FEE OF $40.00 WILL BE CHARGED TO YOUR ACCOUNT IF FUNDS ARE UNAVAILABLE AT TIME OF TRANSFER *