Guideline on Completing the Recipient Electronic Payment Registration Request Form - United States Vendors Only

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Introduction

The Government of Canada has announced that direct deposit will replace cheques as the method of payment. As a result, for Justice Canada, direct deposit will be mandatory as of April 1st, 2014. The Department is asking you to sign up for direct deposit by completing the "Recipient Electronic Payment Registration Request form".

There are two electronic payment modes available:

• Direct Deposit (DD) - Once payments are deposited, DOJ will send the following information by e-mail: amount of payment, date of payment, invoice number, DOJ reference number, and brief description of the payment. This e-mail notification will act in lieu of a cheque stub.
• Electronic Data Interchange (EDI) - To enrol in EDI you must contact your financial institution to ensure that the account is EDI-capable. There may be a fee for this service, as the financial institution notifies its clients according to its own criteria.

Changes to bank account used

If you wish to make any changes to the bank account used for payments (change of address, financial institution, branch, account number, etc.) you must complete a new Recipient Electronic Payment Registration Request form. When you request one of these changes, DO NOT CLOSE the present account until you receive your payment in accordance with that change.

Completing of Form

There are three sections of the Recipient Electronic Payment Registration Request form that must be completed by the recipient.

1 - Types of Request

Please complete this section by filling out one of the three request types described below.

New request

If you choose to sign up for electronic payments with DOJ, please check the "New request" box

Change

If you are already registered for electronic payments with DOJ, however, wish to modify your banking information or mode of electronic payment, please select the "Change" box and mark all other boxes that apply to your change request.

2 - Recipient Information and Authorization

This section must be completed, signed and dated by the appropriate person (or persons) in order to authorize the electronic payment enrolment request, or to modify or cancel electronic payments.

If the recipient is an individual

Please enter your name, address and telephone number AS WELL AS AN E-MAIL ADDRESS so that DOJ can send e-mail notices and confirm receipt of payment. Also, you must sign the form in this section in order to authorize your request.

If the recipient is an organization

Please enter the name and address of your organization and make sure to complete the "Name of payment contact" field with the name of the contact person from your organization. Please also include the contact person's telephone number AND E-MAIL ADDRESS so that DOJ can send e-mail notices and confirm receipt of payment.

Also, authorized representative(s) must include their name, position, telephone number and signature, in order to authorize the request.

This section allows for up to two people to sign the form, in cases where the recipient requires two signatures for authorization, to receive, modify or cancel electronic payments.

3 - Banking Information

If you attach a void cheque

Please attach a void cheque and complete fields 1, 2, 3, 4 and 5 of this section. The void cheque must be from the account you wish to use for electronic payments. A sample of a void cheque is provided below identifying where the transit, bank and account numbers are located.

If you do not attach a void cheque

If you do not provide a void cheque, the financial institution must validate the banking information by completing fields 6, 7 and 8 of the form. The financial institution must provide the name, address and telephone number of the financial institution, bank stamp and sign the form.

4 - For Department of Justice Canada Only

This section is strictly reserved for DOJ's use only.

SENDING YOUR REQUEST TO THE DEPARTMENT OF JUSTICE CANADA

Please send the duly completed form with original signature(s) to the following address:

For Goods and Services Suppliers

Chief, Accounting Services
Room 1452, East Memorial Building
Department of Justice Canada
284 Wellington Street
Ottawa, Ontario K1A 0H8

For Grants and Contributions

Manager, Grants and Contributions Financial Services
Room 6250, East Memorial Building
Department of Justice Canada
284 Wellington Street
Ottawa, Ontario K1A 0H8

Please write the following on the envelope: "To be opened by addressee only".

Your personal information are requested and compiled by the Department of Justice Canada for the purpose of administering the electronic payment program. The information is mandatory in the case where a Recipient decides to participate in the program. This information will be protected and used in conformity with the Privacy Act. Under the Privacy Act, each Recipient has access to their personal information and has the right to demand any modification. These information will be maintained by the Department of Justice.

Important:

• For Electronic Data Interchange (EDI), compliancy must be confirmed by your financial institution and you may be charged EDI service fees.
• Note that Direct Deposit payments carry no stub information.

1 - TYPE OF REQUEST

•  New request
  •  Direct Deposit (DD)
  •  Electronic Data Interchange (EDI)
•  Change
  •  to banking information (provide a new blank cheque)
  •  from Direct Deposit (DD) to Electronic Data Interchange (EDI)
  •  from Electronic Data Interchange (EDI) to Direct Deposit (DD)

2 - RECIPIENT INFORMATION AND AUTHORIZATION

Name of Organization or Name of Individual (recipient):

Address:

Name of Payment Contact (please print):

City:

Telephone:

Fax:

State:

Zip Code:

E-mail for Payment Notifications (please print):

Name(s) and Title(s) of Authorized Representative(s) and Signatory(ies), for organizations only (please print):

Telephone:

I, as an authorized representative of the above mentionned organization or as an individual entitled to receive payment from the Government of Canada,authorize the Receiver General for Canada to deposit the payment directly into the account below and to receive payment advices electronically until further notice.

Signature:

Date:

Signature:

Date:

3 - BANKING INFORMATION

Please attach a blank cheque from your bank account with "Void" written on it and complete fields 1, 2, 3, 4 and 5 below with your banking information.

1 Bank Sort Code/ABA Number (9 digits):

 

2 Swift Code (11 digits):

 

3 Account Number (17 digits):

4 Name(s) of Account Holder(s):

5 Type of account:

Chequing

Saving

If you do not attach a void cheque, your financial institution must confirm your banking information by completing fields 6, 7 and 8 below.

6 Financial Institution Name, Address, Zip Code and Telephone Number:

7 Signature of Financial Institution Representative:

8 Financial Institution Stamp:

4 - FOR DEPARTMENT OF JUSTICE CANADA ONLY

PROCESSED BY

Name (please print):

Vendor Code:

Signature:

Date:

VERIFIED BY

Payment Method Changed

Name (please print):

Signature:

Date:

Print

JUS 778USAe (2014/07)