Direct Deposit To Joint Account

Payroll Direct Deposit Instructions
Please complete and submit this form to your employer to have your paycheque automatically deposited into your Scotiabank account.

To:

Kennedy House
(INSERT NAME OF YOUR EMPLOYER)

Please accept these instructions to automatically deposit my paycheque into my bank account as outlined below:

Employee information
Telephone No.

EMPLOYEE NAME

905-718-4218 cell
905-425-4218 home

Brent Wilson
Address

148 Queen St.
City

Postal Code

Whitby

K9V 1H1

EMPLOYEE NUMBER (IF APPLICABLE)

DEPARTMENT (IF APPLICABLE)

Employee Bank Account Information
Institution

THE BANK OF NOVA SCOTIA

Number

Customer Account Number

002

37846 02899 81
Transit

I am advising the Company to change my payroll direct deposit as indicated above. I understand that
Scotiabank is not responsible for veryifying these payments to my account. I will notify the Company promptly in writing if I close or make changes to my account.

Authorized by:
December 13, 2014
Signature:

Date:

Please forward the complete request to the appropiate department in your company. Some employers may ask you to attach a voided cheque. You may wish to keep a copy of the complete form for your records.

1662613 (02/10)

Registered trademark of The Bank of Nova Scotia

Brent Wilson
148 Queen St.
Lindsay, ON K9V 1H1 [e-mail]

Date 2 0 Y Y - M M - D D
Y Y YY M M D D

$
/100 DOLLARS

PAYTO THE
ORDER OF
THE BANK OF NOVA SCOTIA www.scotiabank.com 1-800-4-SCOTIA

MARKHAM MAIN
101 MAIN STREET N.
MARKHAM, ONTARIO
L3P 1X9
MEMO

007

37846

002

04562

02899

81