Payment Registration Form

Power Plus Account Information

Power Plus Account Number (last 4 digits)

Name and Email

First Name

Last Name

Phone

Alternate Phone

Contact Information

Unit Number

Street Address

City

Province

Postal Code

Organization Information

Account/Organization Name

Is the Payee name different than the Organization name? No Yes

banking Information

Bank Number (3 Digits)

Bank Name

Transit Number (5 Digits)

Account Number (12 Digits Max.)

Void Cheque Upload

note: cheque image is to verify banking info, and is optional

Upload Copy of Void Cheque

Account Updates

Note: All account owners will be responsible for updating their account information with Recycle Plus if any changes occur in the future.

I understand and acknowledge

Note: I understand and acknowledge that all information is correct to the best of my knowledge and if I have entered any incorrect information, there is no liability to Recycle Plus and Signature Support Services Society.

I understand and acknowledge

Payment Registration Form

Power Plus Account Information

Name and Email

Contact Information

Organization Information

Payee Information (if different from Account or Organization name)

Payee Address

banking Information

Void Cheque Upload

Account Updates

Thank you!

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