The City of Winnipeg
DIRECT DEPOSIT APPLICATION FORM
March 2020
Direct Deposit Form - Vendor
FOR OFFICE USE ONLY Date Received:
Confirmed with vendor on: Vendor Number:
Name: Location Number:
Telephone Number: Date Entered:
Approved: Initials:
Please forward completed and signed form to:
The City of Winnipeg
Financial Services Treasury
Main Floor, 510 Main St.
Winnipeg, MB R3B 1B9
Attention: Supervisor of Treasury
NOTE: Incomplete forms will be returned
Name of Organization/Vendor Address of Organization/Vendor
Cont
act Name Telephone Number City Prov Postal Code
Email Address for Remittance Advices
Signature (Must be signed in ink)
Date
Financ
ial Institution/Bank Address of Financial Institution/Bank
Trans
it/Branch Number Institution Number Account Number
*Att
ach original void cheque as verification of above banking information.
Trans
it/Branch Number Institution Number Account Number
Is acc
ount in Organization/Vendors Name? Yes No (If No, application cannot be processed)
Name and Title of Bank Officer Bank Domicile Stamp (Please stamp in space provided)
Addr
ess of Financial Institution/Bank
Telephon
e Number
Signa
ture of Bank Officer
Direct Deposit Application Checklist:
Part 1 completed by Vendor
Attach an original personalized void cheque
If unable to supply an original personalized void
cheque, have Part 2 completed by Financial
Institution/Bank
Return original form (and cheque) to Financial
Services Treasury office
PART 1: TO BE COMPLETED BY VENDOR
PART 2: TO BE COMPLETED BY FINANCIAL INSTITUTION/BANK
DD/MM/YYYY
March 2020
Direct Deposit Form - Vendor
INSTRUCTIONS TO COMPLETE A DIRECT DEPOSIT APPLICATION FORM
o Name and address in Part 1 must exactly match the Vendor’s personalized void cheque and invoices.
o Enter the Transit/Branch Number, Institution Number, and Account Number for depositing your funds. Attach an original
personalized void cheque showing the same information to this form.
o If this is not possible, have this information confirmed in Part 2 by your Financial Institution/Bank.
o You can find the required information on the bottom left corner of your personalized cheque as shown below.
EX
AMPLE: || 798 || 00026 || 002 || 1234 567
Chq# Transit# Inst# Account #
Tr
ansit Number: 0 0 0 2 6 (must be 5 digits)
Ins
titution Number: 0 0 2 (must be 3 digits)
A
ccount Number: 1 2 3 4 5 6 7 (up to a maximum of 12 digits)
o The account you identify must be active and hold Canadian funds at a financial institution in Canada.
o PLEASE FORWARD COMPLETED FORMS TO:
The City of Winnipeg
Financial Services Treasury
Main Floor, 510 Main St.
Winnipeg, MB R3B 1B9
Attention: Supervisor of Treasury
o When changing or closing accounts, you must send a new Direct Deposit Application Form to Treasury immediately.
o Email: FIN-EFT-Advice@winnipeg.ca for any questions or to request new forms.