Term Deposit Automatic Renewal Authorization Form
Use this form to authorize how your term deposit should be handled at maturity. Please provide accurate instructions and confirm your renewal preferences before submission.
Account and Deposit Details
Full Name
*
First Name
Middle Name
Last Name
Contact Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Term Deposit Reference or Account Nickname
Original Maturity Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Renewal Authorization Preferences
What should happen at maturity?
*
Automatically renew principal and interest
Automatically renew principal only
Do not renew and pay out at maturity
Renewal term
*
Please Select
1 month
3 months
6 months
12 months
24 months
How should interest be handled?
*
Add to principal
Pay out separately
Pay to linked account
Authorization and consent
*
I authorize the selected renewal instruction for this term deposit at maturity and understand it will remain in effect until I change or cancel it.
Confirmation and Signature
Confirmation
*
I confirm the instructions are accurate and I understand I am responsible for any changes before maturity.
Signature
*
Date Signed
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Preferred Notice Method
Email
Phone
Submit
Submit
Should be Empty: