Edi/Eft Enrollment Form Ap9088(08-01)

(Rev.1015)

14 Fultz Blvd Winnipeg MB R3Y 0L6

Canadian EFT Enrollment Form

THIS FORM MUST BE ACCOMPANIED WITH A COPY OF A CHECK OR ROUTING INFORMATION PROVIDED ON BANK LETTERHEAD

Type of Request: / New EFT set up Modify/Change of banking information Delete/Remove bank information
Type of modification: Co.Name Address Contact Name Email Fax Number Tel. Number Tax ID #
Remittance Communication Details Banking Info.
VENDOR INFORMATION
Company Legal Name:
Company Doing Business As (if other than Legal Name):
Vendor: Head office Branch CP Vendor No.: ______CP Contact Name:
* Your7 digit vendor no. can be found on your CP cheque stub OR on bottom left hand corner of your Remittance Details
CONTACT INFORMATION
Mailing Address
Street Address: / Payment Remittance Address
Street Address:
P.O. Box # /Station # (if applicable): / P.O. Box # /Station # (if applicable):
City, Province/State: / City, Province/State:
Country, Postal Code/Zip Code: / Country, Postal Code/Zip Code:
Sales Account Manager’s Name: / Accounts Receivable Manager’s Name:
Phone Number: / Phone Number:
E-Mail Address: / E-Mail Address:
Fax Number: / Fax Number:
AUTHORIZATION DETAILS
AR Manager or Controller’s Name (printed) / Title
Signature of AR Manager or Controller / Date
TAX IDENTIFICATION NUMBER
(Please provide W8 if applicable) – this section MUST be completed:
Type of business: Corporation Partnership Fiduciary Individual/Self-Employed
Reg’d proprietor (unincorporated) Other: Federal Business Number/Social Insurance Number: ______
GST REG. Number: / BC PST REG. Number: / PST-______
QST REG. Number*: / TQ / SK PST REG. Number:
MB PST REG. Number: / US FED TAX ID Number**:
Note: *The QST registration number should have 15 characters: 9 digits, followed by the letter TQ and 4 more digits.
** Required if US address
Invoice Currency: CAD USD (W8 required) Other (please specify)
REMITTANCE COMMUNICATION DETAIL OPTIONS
Please choose one of the following options: Option A - EDIOption B - EFT w/ Fax AdviseOption C - EFT w/Email Advice
Option A - EFT - electronic funds transfer (EFT) payment with remittance detail via fax #: (____) _ _ _ - _ _ _ _
Option B - EFT - electronic funds transfer (EFT) payment with remittance detail via E-Mail:
______ (ie: )
BANK INFORMATION
Please select which bank document is included with this application *document MUST be included:
Bank document: Void Check Letter from Financial Institution on bank letterhead
Vendors are responsible for notifying Canadian Pacific of any changes to banking information.

"FACSIMILE AND INTERNET (INCLUDING E-MAIL) ARE NOT SECURE MEDIUMS OF COMMUNICATION AND CANADIAN PACIFIC RAILWAY (CPR) CANNOT GUARANTEE THE PRIVACY OF INFORMATION SENT TO CPR VIA FACSIMILE OR THE INTERNET AND DISCLAIMS ANY RESPONSIBILITY FOR ANY UNAUTHORIZED USE OF INFORMATION OR DATA CONTAINED IN THIS DOCUMENT AND EXCHANGED BETWEEN CPR AND VENDOR VIA FACSIMILE OR THE INTERNET. "

(Rev.1015)

14 Fultz Blvd Winnipeg MB R3Y 0L6

Please return the completed form along with a void cheque via email to: