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Direct Deposit Enrollment Request - New Zealand

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.

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 the enrollment 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) :
Address :
Is this a new address? Y/N
Telephone Number :

Part B

Select the payment(s) you wish to receive by direct deposit.

Enter the number associated to each type of payment you wish to receive.

Service Canada

Old Age Security (OAS) : Y/N
International Agreements - (OAS) : Y/N
Canada Pension Plan (CPP) : Y/N
International Agreements - (CPP) : Y/N
Social Insurance No. (9 digits) :

Canadian Government Annuities : Y/N
Contract No. (10 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) :

Compensation

Canadian Forces Pension : Y/N
Public Service Pension : Y/N
RCMP Pension : Y/N
Judges' Pension : Y/N
Pension No. (9 digits) :
Members of Parliament Retiring Allowances : Y/N
Personal Record Identifier (9 digits) :

Part C

To enroll in Direct Deposit, attach a voided cheque (a blank personal cheque with "void" written on it). Be sure to sign at the 'X' below in box 8.

If you do not enclose a voided cheque, fill in boxes 1 and 2. Your financial institution should confirm this information by completing boxes 3, 4 and 5.

Direct Deposit Routing Number

All fields must be completed with zeros from the left.

Bank / Branch Code (6 digits) :
Account Number (7 digits) :
Suffix (3 digits) :
Name(s) of account holder(s) :
Financial institution name, address and postcode :

Stamp may be used

Signature of financial institution official :
Date (yyyy-mm-dd) :
Telephone Number of financial institution :

I, as the person entitled to receive the aforementioned payment(s) and in lieu of my receiving a Receiver General cheque for it, hereby authorize the Receiver General for Canada to convert Canadian Dollars to New Zealand dollars and to deposit the payment(s), until further notice, into my account noted herein by means of Direct Deposit. I hereby agree to accept the exchange rate applied to the payment(s). I also agree that neither the Canadian government nor its agents shall be liable to myself or any third party for any special, consequential or incidental damages arising from delay.

Signature :

Date (yyyy-mm-dd) :

How to enroll

Enrollment for Direct Deposit is easy. Complete the form and mail it to the address below.

CHEQUE REDEMPTION
CONTROL DIRECTORATE
P.O. BOX 7000
MATANE, QC. CANADA
G4W 4T5

The first direct deposit will be made approximately three months after receipt of your completed enrollment form. Your payment will be deposited into your account in New Zealand dollars. Please note that the amount of your payment may vary from month to month depending on the exchange rate applied. You should verify that your deposit has been made each month.

Need some help with this form?

For information about direct deposit enrollment, call 0-800-450-317 between the hours of 8 a.m. and 8 p.m., Eastern time.