Direct Deposit form - ProTemps Canada

Direct Deposit ? Pre-authorized credit Form

Direct Deposit Authorization

To have your cheque deposited directly to your bank or other financial institution, please complete the authorization and details below and return to ATTN: Payroll Dept.

Name: Address: City/Province:

Signature: Postal Code:

Please deposit the ___________________ payable to me/us directly to my/our account (details below). (payroll/annuity/pension, etc.)

Details of the account to which payments are to be deposited:

Bank or Financial Institution Name: Address of branch: City/Prov:

Postal Code:

Direct routing number: Institution No.

Account Number: Branch Transit No:

Please attach a sample cheque marked "VOID"

103, 10320 ? 102 Avenue, Edmonton, AB T5J 4A1 Phone: (780) 425-9000 Fax: (780) 426-3413

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