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This document outlines the process for submitting a Banking Account Change Request in Canada, including necessary business information and instructions for completing the form. It emphasizes that the existing account must remain open until the new account is verified and requires a voided cheque or bank letter for the new account. Additionally, it includes an acknowledgment section for the client to certify their authority to make the request.

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57 views2 pages

Google

This document outlines the process for submitting a Banking Account Change Request in Canada, including necessary business information and instructions for completing the form. It emphasizes that the existing account must remain open until the new account is verified and requires a voided cheque or bank letter for the new account. Additionally, it includes an acknowledgment section for the client to certify their authority to make the request.

Uploaded by

bmal46833
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Banking Account Change Request – Canada

1 Business Information

Business DBA Name: Merchant #:

Business Legal Name: Merchant Email:

2 Instructions
● If this change is due to a change ownership, do not complete this form.
● Keep the existing bank account open until funds correctly deposit into the new account stated below.
● Provide a copy of a voided cheque or bank letter (see second page) associated with the new account.
● This change request only applies to the account identified in this form. If you are receiving funding from any other payment
provider you must contact that provider directly to request a similar change if necessary.
● Email the completed form and voided cheque or bank Pad agreement to [email protected]. If the legal name of the business
Is changing complete the legal business amendment form and submit along with this form.
● Contact your Account Manager or customer service number listed on your statement for any questions.

3 Enter your new cheque account numbers


*Only Cheque accounts are allowed. See next page for instructions on how to locate the routing and account number.

Transit/Routing # DDA/Account #

Current banking information

New banking information

Bank change applies to: Credits (Deposits) & Debits (Fees) Debits (Fees) Credits (Deposits)

4 Acknowledgement
As Client or as Client’s authorized agent, I certify that I have the legal capacity and am authorized to submit this change request
and form and that Client is accountholder of both Current Account and New Account. I authorize Fiserv and its respective agents,
affiliates, and partners, acting to perform under Client’s Card Acceptance Form (and incorporated Terms and Conditions, or the
“Agreement”) with either such party to make any debits or credits to the New Account and take all other actions in relation to
New Account and Current Account as specified in this form and further provided in the terms and conditions of the Agreement
between the applicable party and Client

Legal Signer’s Printed Name Date

Legal Signer’s Signature Title

BankingCanada 09.21
Voided Cheque Sample

PAD Agreement / Bank Letter


The following requirements must be met to use a PAD agreement.
• All verbiage must be pre-printed, if handwritten a bank stamp is required.
• Legal business name or DBA/Account name displayed on document.
• Bank account information displayed on document.
• Full page is visible, document cannot be cut-off.
• If using a bank letter, bank logo is required.

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