Direct deposit request form

Fill out the form below and press the "Next" button to continue or access the complete instructions.

1 – Type of request

NRC contact name (required)

Please select your type of request (required)

2 – Recipient information and authorization

Name of organization or name of individual (recipient) (required)

Canada Revenue Agency Business number (BN) (9 digits)

Address (required)

City (required)

Province (required)

Postal code (required)

Name of payment contact

Telephone

Fax

Email for payment notifications (required)

Name(s) and title(s) of authorized representative(s), for organizations only

Telephone of authorized representative(s)

3 – Banking information

Attach a blank cheque from your bank account with "Void" written on it otherwise complete the relevant section of the form.

1. Branch number (5 digits)

2. Financial institution number (3 digits)

3. Account number (up to 12 digits)

4. Name(s) of account holder(s)

The information you provide to the National Research Council Canada (NRC) is used for the purpose of processing electronic payments. Information on this form is subject to the provisions of the Access to Information Act and Privacy Act. Personal information is stored in personal information bank PSU 931.

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From: National Research Council Canada

Date modified:: 2017-04-28

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Direct deposit request form

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