EDI/EFT ENROLLMENT FORM AP9088(08-01)
US ACH/EFT Enrollment Form
THIS FORM MUST BE ACCOMPANIED WITH A COPY OF A CHECK OR ROUTING INFORMATION PROVIDED ON BANK LETTERHEAD
|Type of Request: | New ACH/EFT set up Modify/Change of banking information Delete/Remove bank information |
|Type of modification: Co.Name Address Contact Name Email Fax Number Tel. Number Tax ID # |
|Remittance Communication Details Banking Info. |
|VENDOR INFORMATION |
|Company Legal Name: |
|Company Doing Business As (if other than Legal Name): |
|Vendor: Head office Branch CP Vendor No.: _ _ _ _ _ _ _ CP Contact Name: |
|* Your7 digit vendor no. can be found on your CP check stub OR on bottom left hand corner of your Remittance Details |
|CONTACT INFORMATION |
|Company Address |Payment Remittance Address (where a check would be mailed) |
|Street Address: |Street Address: |
|P.O. Box # /Station # (if applicable): |P.O. Box # /Station # (if applicable): |
|City, Province/State: |City, Province/State: |
|Country, Postal Code/Zip Code: |Country, Postal Code/Zip Code: |
|Sales Account Manager’s Name: |Accounts Receivable Manager’s Name: |
|Phone Number: |Phone Number: |
|E-Mail Address: |E-Mail Address: |
|Fax Number: |Fax Number: |
|AUTHORIZATION DETIALS |
| | |
|AR Manager or Controller’s Name (printed) |Title |
| | |
|Signature of AR Manager or Controller |Date |
|TAX IDENTIFICATION NUMBER |
|(Please provideW9/ W8 if applicable) – this section MUST be completed: |
|Type of business: Corporation Partnership Fiduciary Individual/Self-Employed |
|Reg’d proprietor (unincorporated) Other: Federal Business Number/Social Insurance Number: _____________________ |
| |
|GST REG. Number: |
| |
|BC PST REG. Number: |
|PST-____________________ |
| |
|QST REG. Number*: |
|TQ |
|SK PST REG. Number: |
| |
| |
|MB PST REG. Number: |
| |
|US FED TAX ID Number**: |
| |
| |
|Note: *The QST registration number should have 15 characters: 9 digits, followed by the letter TQ and 4 more digits. |
|** Required if US address |
|Invoice Currency: USD (W9 and/or W8 required if applicable) CAD Other (please specify) |
| |
| |
| |
|REMITTANCE COMMUNICATION DETAIL OPTIONS |
|Please choose one of the following options: |
|Option A - EFT - electronic funds transfer (EFT) payment with remittance detail via fax #: (____) _ _ _ - _ _ _ _ |
|Option B - EFT - electronic funds transfer (EFT) payment with remittance detail via E-Mail: |
|_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (ie: Accountsreceivable@) |
|BANK INFORMATION |
|Please select which bank document is included with this application *document MUST be included: |
|Bank document (Mandatory): Void Check OR Letter from Financial Institution on bank letterhead |
|Provide Sample Invoice (Mandatory): Sample Invoice Included |
|Vendors are responsible for notifying Canadian Pacific Railway of any changes to banking information. |
Please return the completed form along with a void cheque via email to:
US_APVendorMaintenance@cpr.ca and AP_EFT@cpr.ca
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