Authorization for One Purchase Transaction by Telephone

Dear Sir / Madam,

This for contains information that would enable you to transfer sum of money to the clinic’s account in Toronto Canada.

Please print the information enclosed and give it to your bank officer to use the information for the transfer.

Once the amount is transfer to our account, then please send the transfer form to our office to fax number ( +1-416-207-0272 ) so that the amount will be credited to your account at the clinic. Thank you.

Bank’s Information
Bank's Name TD Canada Trust
Bank's Address 3868 Bloor Street West,
Toronto, Ontario, Canada M9B 1L3
Bank's Phone +1-416-236-1095
Bank's Code 004
Branche's Number 02352
Account Number 7200420
Swift Number TDOMCATTTOR
Clinic’s Information
Clinic's Name Naturopathic and Allergy Clinic
Clnic's Address 5468 Dundas Street, West, Suite 101,
Toronto, Ontario,  Canada, M9B 6E3
Clinic's Phone Number +1-416-207-0207
Clinic's Fax Number +1-416-207-0272
Clinic's e-Mail Address clinic@4162070207.ca
Clinic's Web Site www.4162070207.ca





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