United States Form Completion Instructions

A direct deposit form has been designed to support the capture of key information from pensioner's wishing to enrol on direct deposit in the United States. The following is a step by step procedure developed to guide the pensioner in the proper completion of the form.

Completion Instructions

The United States enrolment form is divided into three sections. They are:

  • Part A - Pensioner Identification Information,
  • Part B - Pension Program identification; and
  • Part C - Identification of the Financial Institution.

Part A - Pensioner Identification Information

This image is a screen capture of Part A of the United States enrolment form

Part A provides space for you to identify your name, address, mail code, and telephone number. The following is a step by step procedure.

Step 1 and 2

Enter your surname and given name and initials in the boxes provided. One letter per box. Please use capital letters.

Step 3

Enter your address information including the name of the city, country and zip code.

Step 4

Confirm if the address is new by entering (checked box) in yes or no.

Step 5

Enter your area code and telephone number in the event that you need to be contacted to seek clarification on the information provided.

You have now completed Part A, Pensioner Identification Information.

Part B - Pension Program Identification

This image is a screen capture of Part B of the United States enrolment form

Part B provides a mechanism for you to specify the payment(s) you want deposited directly into your US account. To enrol, check (checked box) the appropriate box and include one of the following in the space provided: your social insurance number, contract number, file number, pension number, or personal record identifier.

The department responsible for your pension program will use this to find your account and to issue the requested electronic payment.

Step 1

Check off the box(es) checked box for the payment(s) you wish to receive by direct deposit.

Step 2

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

You have now completed Part B - Pension Program identification.

Part C - Identification of the Financial Institution

This image is a screen capture of Part C of the United States enrolment form

Part C provides specific fields for you to capture your direct deposit account information which includes the "transit data" such as the bank and branch and the account number to which the electronic payment is to be directed. For a US direct deposit it is also a requirement to identify the type of account as either a chequing or savings.

To enrol 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, 2, 3 and 4 below. Your financial institution should confirm this information by completing boxes 5, 6 and 7.

Step 1

Enter the Transit/ABA No. which represents the bank and branch. One letter or number per box please using capital letters where applicable.

Step 2

Enter your bank account number one number/character per box. Please use capitals for characters (if applicable).

Step 3

Enter the type of account by entering a check mark (checked box) in either the chequing or savings box.

Step 4

Enter the name(s) of the account holder(s).

Step 5

Enter your bank, branch address and zip code.

Step 6

Please obtain the signature of the financial institution official.

Step 7

Enter your bank area code and telephone number, in the event that they need to be contacted for clarification on the information provided.

Step 8

The beneficiary must sign and date the bottom of the enrolment form. If the individual completing this form is a guardian / relative acting on behalf of the beneficiary this enrolment information will not be considered valid without the beneficiary's signature.

For additional information, call 1-800-593-1666 between the hours of 8 a.m. and 8 p.m., Eastern time.