Vendor Banking Information and Authorization

Please complete the form below to expedite invoice payment by the CRA.

If you prefer to submit your information in writing, please fill in this form and mail it to:
Canadian Rheumatology Association
280-13300 Tecumseh Road E.
Suite 386
Tecumseh, Ontario N8N 4R8

If you have any questions, contact our Senior Bookkeeper Lisa Prout at 905 952-0698 Ext. 6.

Personal Information

All fields in this section are required.

First Name

Last Name

Phone

Address

City

Province

Postal Code

Banking Information

Please fill in all relevant fields.

How you would like your invoice(s) settled:

Direct Deposit (for Canadian payments)Wire Transfer (for payments outside Canada)

Institution Name
Transit #

(5 digits)Institution #

(3 digits)Account #

(7 digits)

Bank name
Address
Account/IBAN #
BIC/SWIFT code

Please upload an image of a void cheque, if available.

Acceptable file types are pdf, jpg, gif, or png.

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