SCHOOL DISTRICT No.

73 (KAMLOOPS / THOMPSON)
1383 Ninth Avenue, Kamloops, B.C. V2C 3X7 Telephone (250) 374-0679 Fax: (250) 372-1183

August 8, 2014

Dear Sir/Madam,

In an effort to reduce administration costs and make payments more convenient for our suppliers we are
converting our cheque based payables system to direct deposit/electronic funds transfer.

Please complete the section below, attach a VOID Cheque and fax this request to 250-372-1183.
Alternatively, you may scan the completed form along with a copy of your VOID Cheque and send via email to
finance@sd73.bc.ca.

Thank you,
Finance Department
School District 73

PLEASE COMPLETE ALL AREAS TO SIGN UP FOR DIRECT DEPOSIT

YOUR FINANCIAL INSTITUTION CAN ASSIST IN THE COMPLETION OF THIS INFORMATION
PLEASE PRINT CLEARLY

Payee Name: __________________________________________________

Bank Name: __________________________________________________

Bank Number: (ie. 010) __________________________________________________

Bank Transit Number: (ie. 05280) __________________________________________________

Bank Account Number: __________________________________________________

Email Address for Notification __________________________________________________

Name: __________________________________________________

SIN (Self Employed Worker ONLY) _________________________________________________

Signature: __________________________________________________

WORKING TOGETHER FOR QUALITY PUBLIC EDUCATION