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Student Banking Information for Direct
Deposit - Please return form to
accounting@columbiacollege.ca
Description of Service:
This form contains the banking information required to facilitate direct deposits to your personal Canadian bank
or credit union account.
Section 1 Student Banking Information
Full Legal Name of Individual Receiving a Direct Deposit of Funds from Columbia College
Street Address
City / Town
Province
Postal Code
Phone Number
Section 2 Banking Information - Please fill out below or attach a cheque marked VOID
Name of Canadian Financial Institution
Branch Name
Branch Phone Number
Branch Address
Transit Number
Account Number
Section 3 Depositor Information
Columbia College is hereby requested and authorized to make deposits to my / our account as designated
below which are payments due to me. This authorization may be canceled or the account number changed
by an email to Accounting@columbiacollege.ca at least one week before payments are due to me.
Section 4 Authorized Signature
By signing this document, I agree to the terms and conditions set forth in this agreement.
Account Owner Signature
Account Owner Name and Student Number
X .…………………………………………………….
Date (yyyy-mm-dd)
Bank #