DIRECT Deposit Form (Peterborough Hockey Association)

Print DIRECT Deposit Form
  1. Full name as it appears in Arbiter
  2. (Street, City and postal code)
  3. Example: ###-###-####

  1. Authorization for Direct Deposit

    I hereby authorize the Peterborough Hockey Association to initiate automatic deposits to my account at the financial institution named below. I also authorize the Peterborough Hockey Association to make withdrawals from this account in the event that a credit entry is made in error.

    Further, I agree not to hold the Peterborough Hockey Association responsible for any delay or loss of funds due to incorrect or incomplete information supplied by me or due to an error on the part of my financial institution in depositing funds to my account.

    This agreement will remain in effect until the Peterborough Hockey Association receives a written notice of cancellation from me or my financial institution, or until I submit a new direct deposit form

Banking/Direct deposit information
  1. (5 Digits)
  2. (3 Digits)
  3. (1-12 Digits) Usually found before the (II') symbol. The exact location and number of digits may vary between banks.
  4. (1-12 Digits)
Human Validation