Electronic Funds Transfer (EFT) Registration Form

The City of Medicine Hat is offering payment of invoices, by direct deposit, to our suppliers.

Notification of the invoices paid and the date of deposit will be emailed to the address supplied by you. Please be advised that it is the suppliers’ responsibility to inform the City of Medicine Hat of any changes to bank account numbers or email addresses.

Submit the form below, along with either a void cheque or the account information for direct deposit (available from your financial institution).

If you have any questions please contact Accounts Payable at 403-529-8128.

Receiving bank must be a CANADIAN banking institution. Funds to be remitted in CANADIAN dollars.

Attachment required

• Void cheque; or
• Direct deposit form (from your financial institution)

The undersigned gives the City of Medicine Hat the authorization to use the attached banking information to process electronic payments directly to their bank account through EFT.

By submitting this application/form you acknowledge and agree that any electronic signature provided by you herein is the same as a handwritten signature for the purposes of legality, validity, enforceability, and admissibility.