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Direct Deposit Enrollment Request

This form can only be used for payments deposited in Canada.

Instructions for completing the Direct Deposit Enrollment Request :

You can copy and paste the required form information below into a word processor, provide the appropriate information, print, sign and send by mail.
You can also print this page and fill in the fields by hand and send by mail.

Part A

Please print clearly.

Please keep the appropriate federal government department informed of any change to your mailing address.

Surname :
Given name : Initial(s) :
Street address, Apt. No., R.R. or P.O. Box :
City, Town :
Province :
Postal Code :
Telephone (123-456-7890) :

Part B

Select the payment(s) you now receive by cheque :

Canada Revenue Agency

Income Tax Refund, GST/HST credit, WITB advance payments, and any other deemed overpayment of tax : Y/N
Child Tax Benefit : Y/N
Universal Child Care Benefit : Y/N
Social Insurance No. (9 digits) :

Service Canada

Old Age Security : Y/N
Canada Pension Plan : Y/N
Social Insurance No. (9 digits) :

Canadian Government Annuities : Y/N
Contract No. (11 digits) :

Veterans Affairs Canada

Veterans Affairs Pension or Award : Y/N
War Veterans Allowance : Y/N
Veterans Affairs Financial Benefits : Y/N
File No. (7 digits) :

National Defence and the Canadian Forces

Canadian Forces Pension : Y/N
Pension No. (9 digits) :

Public Service Pension Center

Public Service Pension : Y/N
Pension No. (9 digits) :

RCMP

RCMP Pension : Y/N
Pension No. (9 digits) :

Please attach a blank cheque for your bank account with "VOID" written on it. If you don't have a chequing account, please see Part C of this form.

I, as the person entitled to receive the payment(s) indicated above, authorize the Receiver General for Canada to deposit the payment(s) directly into my account until further notice.

Date (yyyy-mm-dd) :
Signature of Applicant :

(print & sign)
Language Preference :

Do not enclose anything other than your voided cheque with this form.

Mailing address

Mail the completed form to the address shown below. Don't forget to attach your "voided" cheque(s).

CHEQUE REDEMPTION
CONTROL DIRECTORATE
P.O. BOX 5000
MATANE, QC. CANADA
G4W 4R6

Starting up

You should receive your first direct deposit payment within three months after you send us this form. In the meantime, we will continue to send you a cheque.

If for some reason the direct deposit cannot be made into your account, we will continue to send you a cheque.

Depositing payments into different accounts

For example, you can have your Canada Pension Plan payments deposited into one account and your Old Age Security payments into another account. On each blank cheque, write the name(s) of the payments you want deposited into that account. Income Tax refunds and GST/HST credits must be deposited into the same account.

Need some help with this form?

For information about direct deposit enrollment, call 1-800-593-1666 (toll-free) between the hours of 8 a.m. and 8 p.m., Monday to Friday, Eastern standard time. You can also ask your financial institution for help in completing the form.

Canadian Direct Deposit Enrollment Form - Completion Instructions

People who use a TDD/TTY should place calls with the assistance of Bell Relay Service (BRS) operators at 1-800-465-7735.

Part C

If you have enclosed a "voided" cheque, do not have your financial institution complete this part.

Branch No. (5 digits) :

Institution No. (3 digits) :

Account No. (up to 12 digits) :

Name(s) of account holder(s) :

Financial Institution Stamp Here

Provision of the information requested on this form is required to effect direct deposit payments. This personal information will be stored in Personal Information Bank Number PWGSC PPU 085 and is protected under the Privacy Act. Under the Act you have the right to request access to and request correction if erroneous or incomplete. The information is retained for six years after the last administrative action and then destroyed.