CBBenefits Banking Information Request

We are pleased to advise you that Canada Life is able to handle client contributions by directly debiting your churches bank account. If you would like to take advantage of this service, please complete all the required fields below.


Once your information is received, it will take five business days to complete the setup of your banking information.


At Canada Life, we are committed to providing you with the best possible customer service. If you have any questions, please don’t hesitate to contact us.

Banking Information

Client Name and Number: CBBenefits #74855

3 digit number located at the bottom edge of your cheque

5 digit number located at the bottom edge of your cheque

Ensure this field is entered exactly as shown (with or without dashes)

Signor Information



By checking this box we:


Provide authority for The Canada Life Assurance Company (Canada

Life) and our financial institution indicated below to debit our company’s bank account in

accordance with the instructions provided from time to time by our company’s plan

administrator(s). The submission of such instructions to Canada Life shall be considered

to be authorization for the withdrawal listed therein as if our company had signed a

cheque.


Understand and agree that in order for a particular contribution to be effective and

the amounts to be deposited to each plan member’s account on the same day:

• Any written instructions must be received by 2:00 p.m. ET*

• Any online instructions via grsaccess.com must be submitted by 4 p.m. ET*

*Cutoff times are based on closing of the Toronto Stock Exchange (TSX) at 4 p.m. ET.

We understand our written or online instructions must include the following information:

1. The total amount of the contribution due (which will be the amount to be withdrawn

from the bank account above), and

2. A listing/or input setting out each plan member’s name and the dollar amount to be

deposited to their account.

Any instructions for contributions received after the times noted above will be effective

and deposited to each plan member’s account on the next business day. The withdrawal

from our company’s bank account will be initiated on the effective date of the

contribution.


Further agree to the following terms and conditions:

1. Any reproduction of this PAC agreement will be as valid as the original.

2. If our financial institution, branch or account number changes we will immediately

update the banking information grsaccess.com or notify Canada Life.

3. We agree to regularly review our bank account information. If we question or disagree

with the amount withdrawn or any account changes, we will notify Canada Life in

writing within ninety (90) days of the withdrawal or account changes; otherwise, we

agree that the withdrawal or account changes will be considered to have been properly

made.

4. If there is not enough money in the bank account to cover the amount specified to be

withdrawn (not sufficient funds also referred to as “NSF”), we authorize Canada Life to

immediately make a second attempt to withdraw the amount due. If the second

attempt is denied due to NSF (or if Canada Life decides, in its sole discretion, not to

make a second attempt), we understand that this PAC agreement may be suspended

and possibly cancelled by Canada Life. We understand that we are responsible for any

NSF charge(s). We agree that if this PAC agreement is suspended by Canada Life,

Canada Life may, in its sole discretion require a new PAC agreement.

5. We hereby waive any requirement of prior written notice to us of the assignment of this

PAC agreement.

6. We may cancel this PAC agreement at any time by sending Canada Life written notice.

Such cancellation will be effective upon receipt of our written notice. This PAC

agreement may also be cancelled if any withdrawal is not permitted or is reversed by

the financial institution or upon thirty (30) days written notice to us. We may obtain a

sample cancellation form or more information on our right to cancel this PAC

agreement by contacting our financial institution or by visiting payments.ca.

7. We have certain recourse rights if any debit does not comply with this PAC agreement.

For example, we have the right to receive reimbursement for any debit that is not

authorized or is not consistent with this PAC agreement. To obtain more information

on our recourse rights, we may contact our financial institution or visit payments.ca.

8. We certify that all persons whose signatures are required to authorize this PAC

agreement have signed below.


I agree to the Terms and Conditions shown above.