FIDÉLITÉ PROGRAM
CANCELLATION FORM
Annual pass with pre-authorized debit (personal PAD)
Please ensure that all sections of the application have been completed.
 1. ENROLMENT CANCELLATION (Complete sections 1, 2, 3 and 4)
Please indicate the last month you will use the pass :
Type of pass: ADULT REGULAR ADULT INTERZONE  ADULT EXPRESS  SENIOR
Reason for cancellation :  
 2. MEMBER INFORMATION
Last Name:  First Name:   Gender: 
Year of Birth: My Passe-Partout Plus card no.: CF-
(6 digits under the photo)
RESIDENTIAL ADDRESS

Number: Street: Apt. No :
City : Postal Code : E-mail :
Home Telephone :( ) -
Work Telephone :( ) - Extension
 3. MEMBER STATEMENT

To cancel enrolment in the FIDÉLITÉ Program, complete the cancellation form and submit it to the STO’s Finance Departmen at least 10 business days before the next scheduled debit date11.

  • I acknowledge that my FIDÉLITÉ Program Passe-Partout Plus pass will become invalid on the first day of the month following the notice of cancellation.
  • If my cancellation request is submitted before the one-year term has ended and for a reason other than those accepted2, I shall owe the discount of 10% for each month of use of the annual pass (every month started shall be due).
  • Within 30 days following termination of my enrolment, I shall return the Passe-Partout Plus pass linked to the contract to the STO3, failing which an additional amount of $20.00 (tax exempt) will be debited from my account.

For more information on your right to cancel a PAD (pre-authorized debit) Agreement, contact your financial institution or visit www.cdnpay.ca.

1 Bank account debits are taken on the 25th day of every month or the next business day, if this is a holiday.

2 The annual enrolment can be cancelled at the member's request without any fees owing to the Société de transport de l'Outaouais when the member is unable to use the pass for a period less three months for one of the following reasons:
  • Death of the member;
  • Maternity or parental leave, illness or accident (certificate must be provided);
  • Unexpected move away from the Outaouais area (proof of the new address must be provided);
  • Change in employment (proof of the new place of employment must be provided).
In all cases, the STO's approval is required for the cancellation to become effective.

3The FIDÉLITÉ Program Passe-Partout Plus pass can be returned by mail to the STO’s administration office at 111 Jean-Proulx, Gatineau, J8Z 1T4, or dropped off at one of the STO Service Points (Galeries Aylmer, Les Promenades or STO administration office).

 I have read and agree to the terms and conditions mentioned above.
 4. MEMBER AUTHORIZATION
I hereby cancel my enrolment in the FIDÉLITÉ Program and the authorization to process pre-authorized debits on my bank account. I acknowledge that this cancellation does not terminate any other obligation I may have towards the beneficiary.

Member Signature
Account Holder Signature (if different)
 Date (YY/MM/DD)

To have the cancellation request processed, please send this duly completed and signed form by mail to 111 Jean-Proulx, Finance Department, Gatineau, Quebec, J8Z 1T4, by fax to 819 770-5987, by e-mail to fidelite@sto.ca or dropped off at one of the STO Service Points (Galeries Aylmer, Les Promenades or STO administration office). Please print the form on legal size paper.

For more information, visit sto.ca, write to fidelite@sto.ca or call 819 770-3242.