Financial Services

65 York Street
Sackville, NB E4L 1E2
Canada
www.mta.ca

Dear Employee/Student:

Mount Allison University is offering electronic fund transfer (EFT) payments for your expenses
under $10,000. EFT is a faster more secure way for payments to be made. If you would like to
sign up for EFT payments, please fill out the form on the reverse and return with a void cheque
or letter from your bank. The forms can be sent via fax: (506)364-2216,
email:purchasing@mta.ca, or mail: Mount Allison University, Procurement, 65 York Street,
Sackville, NB, E4L 1E4.

Information that was previously provided on a cheque stub will now be sent to the email address
you provide on the form.

Should you have any questions or concerns regarding this process, please contact me.

Sincerely,

Cindy Landry, CPA, CA

Assistant Controller
Mount Allison University
65 York Street, Sackville NB E4L 1E4

Tel: (506) 364-2242

E-mail: celandry@mta.ca
 Authorization Agreement

I hereby authorize Mount Allison University to initiate EFT payments to my account at the
financial institution named below for payment of my expenses or student payments.

Further, I agree not to hold Mount Allison University responsible for any delay or loss of funds
due to incorrect or incomplete information supplied by myself, by my financial institution, or due
to an error on the part of my financial institution in depositing funds to my account.

This agreement will remain in effect until the relationship with Mount Allison University ceases,
or until I submit a new direct deposit form to the Financial Services Department.

Please complete the following and provide a void cheque or letter from your bank when
returning this document.

Account Information

Employee/Student name: ____________________________________________________

Employee ID #: ________________

Email for Remittance: _______________________________________________________

Name of Financial Institution: _________________________________________________

Institution Number (3 digits): ____________________

Transit Number (5 digits): ______________________

Account Number: ___________________________________________________________

This is a request to change the current account information.

Please provide current account information ________________________________________

Your Signature: ____________________________ Date: ____________________