Account Type *
Product(s) Required *

Number of Additional Cards Required *
For quantities of cards with different names greater than 10, please enter the first 10 names and our Credit department will contact you for further information.


For your security, please provide a contact number you can be reached at, and we will contact you to obtain your credit card information.

{{pronoun}} authorize FS PARTNERS/UPI Energy FS, and the financial institution designated (or any other financial institution {{pronoun}} may authorize at any time) to begin deductions as per my/our instructions for monthly regular reoccurring payments of all charges arising under my/our FS PARTNERS/UPI Energy FS account(s). {{pronoun}} authorize the balance owing on my/our FS PARTNERS/UPI Energy FS account statement to be:

  • Withdrawn from my bank account on the 20th of the month
  • Charged to my credit card on the 10th of the month

This authority is to remain in effect until FS PARTNERS/UPI Energy FS has received written notification from me/us of its change or termination. This notification must be below. {{pronoun}} may obtain a sample cancellation form, or more information on my/our right to cancel a PAP Agreement at my/our financial institution or by visiting

FS PARTNERS/UPI Energy FS may not assign this authorization, whether directly, by operation of law, change of control or otherwise, without providing at least ten (10) days prior written notice to me/us.

{{pronoun}} have certain recourse rights if any payment does not comply with this agreement. For example, {{pronoun}} have the right to receive reimbursement for any PAP that is not authorized, or is not consistent with this PAP Agreement. To obtain a form for a Reimbursement Claim, or for more information on my/our recourse rights, {{pronoun}} may contact my/our financial institution or visit

Note: For Commercial accounts only

After submitting your online application, please print and fill out the Bank Information Release Form (PDF). You may mail, fax, or email it to us at:

UPI Energy FS
105 Silvercreek Parkway North, Suite 200
Guelph, ON N1H 8M1
Fax: 519-821-2618