Required fields are marked with asterisks (*)

Electronic Funds Transfer Form
Woolwich Township Accounts Payable Department

Program details:

To enroll, please complete this application and upload a void cheque below.
Vendors will receive EFT as a direct deposit to a Canadian chartered bank account.
Vendors must be a registered business, and include their HST number where applicable.
The Township must have an ongoing purchasing relationship with the vendor, resulting in regular invoicing and payment transactions.
If an incomplete or erroneous transfer occurs because the Township used the Vendor's EFT information incorrectly, the Township remains responsible for making a correct payment.
If an incomplete or erroneous transfer occurs because the vendor provided inaccurate or outdated EFT information and payment has already been released, the vendor is responsible for the recovery of such funds. If payment has not been released, all future payments will be suspended until receipt of correct EFT information is provided or a formal request to withdraw from EFT received.
The Township will not be held liable for deposit errors as a result of incorrect financial information from the vendor or it's financial institution.
Township employees seeking reimbursement via EFT are required to indicate their preference to use Payroll information.
The Township must receive thirty (30) days written notice for any change to the banking information on an existing EFT account.
A minimum of thirty (30) days written notice is required for withdrawal from the EFT program.

Vendor Name

Mailing Address

Phone Number

HST Number

Accounts Receivable Contact Name

Accounts Receivable Phone Number and Extension

Accounts Receivable Remittance Advice Email

Are you a Vendor or Township of Woolwich Employee?

Vendor

Township of Woolwich Employee

Signature

Clear

I confirm on behalf of the vendor that the information provided on this form is true and accurate. By signing, I authorize the Township of Woolwich to use the attached banking information for the purpose of Electronic Funds Transfer payments.

Yes

Name of Signing Authority

Date of Application

Information on this form is collected under the guidelines of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA), and will be used solely for the purposes of Electronic Funds Transfer.

Electronic Funds Transfer Form Woolwich Township Accounts Payable Department

Program details:

Electronic Funds Transfer Form
Woolwich Township Accounts Payable Department