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Ministry of Public and Business Service Delivery and Procurement

Direct Deposit or Interac e-Transfer Authorization Form

Form Information

Fields marked with an asterisk () are mandatory.

This form allows you to:

  • Start receiving payments (claims or service reimbursement) directly into your personal or business bank account at a Canadian financial institution.
  • Start receiving payments via Interac e-Transfer to an email address linked to a Canadian bank account, provided you have Autodeposit enabled.(Note: single payment amounts must be less than $25,000).
  • Change the direct deposit information that you have already given us.
  • Change your email address linked to your Canadian bank account for Interac e-Transfer.

Eligible Programs and Payments

This form supports direct deposit or Interac e-Transfer for payments issued under the following:

  • Statutory Accident Benefits out of the Motor Vehicle Accident Claims Fund
  • Property damage road liability claims under the Public Transportation and Highway Improvement Act
  • General liability claims under the Crown Liability and Proceedings Act
  • Payment for legal services or legal disbursements provided to or on behalf of the Insurance and Claims Services Branch (only eligible for EFT registration). Documentation regarding your CRA Business number is also required.

Instructions

  • Complete all required fields in the form.
  • Once finished, click the "Submit Form" button at the end of the form to update your payment information with the Insurance and Claims Services Branch.
  • If you require assistance or have questions about completing this form, please contact the Claims Examiner assigned to your claim.

Client Information

Please provide your legal name. This may be either your full personal name (first and last name) or registered business name. Ensure that the name entered matches with the information we have on file.

Ensure the name matches exactly with the records we have on file.

  • If you are an individual claimant, enter your claim file number.
  • If you are a business, you do not need to provide a claim number. We have provided you with a Participant Code. Please enter the code you were provided onto Section 1 below.

Payment Method Sign-Up

Direct bank deposit is the preferred method of payment. You are encouraged to provide your banking information to receive payments securely and promptly.

  • If you choose to sign up for bank direct deposit, you must also submit a void cheque or a bank statement that includes your full name and banking details for verification purposes.
  • You will receive separate instructions on how to upload the required document using the Ontario Citizen Secure Email platform.

Whether you choose bank direct deposit or Interac e-Transfer, please ensure that:

  • The name on the bank account matches the client information provided in Section 1.
  • The account is held at a Canadian financial institution.

If we are unable to deposit funds into the account you provided, or if the account name does not match the client information, a cheque will be mailed to the address we have on file.

Once you have signed up for a payment method, all future payments will be issued using that method until you submit a new form to request a change.

Bank Account Information

You can find your branch number, institution number, and account number:

  • On your chequebook
  • On your bank statement
  • On a personal deposit slip or cheque
  • Or by contacting your financial institution

Signature

You must attest and date the form to authorize the Ministry to process your payment request.

  • The form must be attested by the account holder or an individual with proper authority.
  • The name of the individual attesting must match exactly with the Ministry's records. If it does not, the form will not be processed.

By attesting and submitting the form, you confirm that the information provided is accurate and authorize the Ministry to deposit payments into the account listed in Section 2.

Changing Your Information

After your request has been processed and the direct deposit starts, it will stay in effect until you change it. You must fill in a new Direct Deposit Request, if you change your:

  • Bank account number
  • Financial institution;
  • Email address linked to your bank account for Interac e-transfer

1. Your Information

Please provide your legal name. This may be either your full personal name (last name and first name) or registered business name. Ensure that the name entered matches with the information we have on file.

You have been provided with a Participant Code in a separate email. Please enter the code in the field below.

2. Payment Method Sign Up

Select payment sign up method(required)
  • Direct bank deposit is the preferred payment method.
  • Funds are deposited directly into your Canadian bank account.
  • To enroll, submit a void cheque or bank statement showing your name and banking details.
  • Upload instructions will be sent separately via Ontario Citizen Secure Email Portal.
  • Your Branch, Institution, and Account Numbers can be found on a cheque, bank statement, or by contacting your bank.
  • Receive claim payments or service reimbursements directly to your bank account via email transfer.
  • Your email must be linked to your bank account with Autodeposit enabled.

Direct Deposit Details

Select one(required)

Enter Your Banking Information

Upload Required for Bank Direct Deposit Sign up

If you choose to receive payments via bank direct deposit, you are also required to upload either a void cheque or a bank statement that includes your full name and banking details. Documentation must be submitted through the Ontario Citizen Direct Secure Email platform. Instructions on how to upload your document have been provided to you in a separate email. Please refer to that message for step-by-step guidance.

Provide your Email Address for Receiving Notification

(Example: name@example.com)

Interac e-Transfer Details

Select one(required)
Autodeposit activated(required)

Autodeposit must be enabled in order to receive an email transfer

(Example: name@example.com)

(Example: name@example.com)

If you prefer to receive notifications of payment to a different email address, please provide your notification email address.

(Example: name@example.com)

3. Attestation and Signature

The personal and financial information you provide on this Direct Deposit or Interac e-Transfer Authorization Form is collected by the Insurance and Claims Services Branch of the Ministry of Public and Business Service Delivery and Procurement. This information is solely used to issue claim payments or health care service reimbursements in accordance with the following legislation:

  • Motor Vehicle Accident Claims Act
  • Statutory Accident Benefits Schedule
  • Crown Liability and Proceedings Act
  • Public Transportation and Highway Improvement Act
  • Financial Administration Act

As such, the collection of your personal and financial information is in accordance with section 38(2) the Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c. F.31. The Insurance and Claims Services Branch is responsible for administering the Motor Vehicle Accident Claims Act, general liability claims against the Crown, and road liability claims. If you have questions about the collection or use of your personal information, please reach out to the ServiceOntario Contact Centre.

Summary

Note: To make changes to the information below, please click the “Back” button (at the top of this page) to access previous pages or “Edit Section” to make corrections.

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