Direct Deposit Request

Please accept these instructions to automatically deposit my cheque into my bank account as outlined below:

Name(Required)

First Last

Email Address(Required)

Address(Required)

Street Address Address Line 2 City Province Postal Code

Bank, Transit and Account Information

Enter Bank, Transit and Account Number Manually

Upload a photo or file with Bank, Transit, and Account information

Institution

Bank Name

Transit/Branch Number(Required)

Institution Number(Required)

Account Number(Required)

File(Required)

Max. file size: 8 MB.

Authorized by:(Required)

Signature

Date(Required)