Accounts Payable AP07
SUPPLIER DIRECT DEPOSIT
Direct Deposit services are currently only available for Canadian bank accounts
Cheques will be issued for all USD payments. If you require a payment to be made in an international currency (other than
USD) please contact Accounts Payable for information on the Wire Payment Process.
Application Type: New Application
Change of Information Cancel Direct Deposit
Please ensure all flags marked as required (*) are completed. Payment to Supplier will not be issued until all
required direct deposit information is received by the University of Windsor.
_________________________________________________________________
Company Information
The Supplier Name and Address provided below, must agree exactly to the following:
Supplier Name and Address on the void cheque or Letter of Guarantee from the bank,
Supplier Name and Address on the submitted PO09 Supplier Update/Addition Form
Supplier Name*:___________________________________________________________________________
Supplier (Remit to) Address*: ________________________________________________________________
________________________________________________________________
Contact Name/Officer*: ______________________________ Title*: ___________________________________
Phone*:_____________________________ Email*:_______________________________________________
Email for where EFT Remittance Confirmation can be sent (If different from above)*: ____________________
__________________________________________________________________
Banking Information
*A void cheque is required to verify all bank information provided below. If void cheque is not available, attach a
Letter of Guarantee from bank confirming banking information. The banking information below must agree exactly
to banking information on the void cheque or Letter of Guarantee from the Bank:
Bank Account No.*: _________________________ Account Type: Chequing
Saving
Bank Institution No.*: ___________ (3 digits) Bank Transit No.*: __________ (5 digits)
Bank Name or Financial Institution*: _________________________________________________________
Branch Address*: ___________________________________________________________________
City*: _______________________ Province*: _________________ Postal Code*: ______________
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Supplier Direct Deposit Form Completion Checklist*:
All required information is completed
Supplier Name and Address agree to the void cheque/Letter of Guarantee from the bank
Void cheque/Letter of Guarantee from the bank has been attached to this application
Application has been signed below, authorizing consent to UWindsor to use the banking information
provided
Authorization
I authorize the University of Windsor to credit the bank account indicated above. I will notify Accounts
Payable in writing if I change the account from one bank or branch to another, or if there is any other
change. I have retained a signed copy of this authorization form. Your typed name below indicates your
approval of the form and confirms that all information is accurate.
Employee’s Signature ________________________________ Date ______________________________
Re: Collection of Personal Information
The information collected for Supplier Direct Deposit is collected under the authority of the University of
Windsor Act and is collected for the purpose of providing direct deposit of funds for payment of invoices.
Information provided to the Finance Department for Supplier Direct Deposit will be used only for that
purpose and will be accessed only by persons so authorized.
OFFICE USE ONLY
__________________________ ___________ __________________________ ______________
Approved by Date System Updated by Date
__________________________ ___________ _______________________
Setup Verified by Date UWINSITE Supplier Number
Submit Form to: suppliers_uwinsite@uwindsor.ca. If there are any questions while filling out the form,
please contact ext. 2081.
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click to sign
signature
click to edit
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