120 Adelaide Street West
Suite 1600
Toronto, Ontario M5H 1T1
T 416-967-7474
F 416-967-1947
www.ieso.ca
FORM OF PAYMENT ACCOUNT INFORMATION
contract.management@ieso.ca
IESOCM-FORM-010(2013-05)
SUBMIT BY E-MAIL (PDF WITH SIGNATURE) TO
settlements@ieso.ca
Pursuant to Section [No.] of the Contract, the Supplier is hereby submitting this completed Form of Payment Account Information to the Buyer.
Capitalized terms not defined herein have the meanings ascribed thereto in the Contract.
Date
Legal Name of Supplier
Name of Contract Facility
Contract Title
(the “Contract”)
Contract Date
Bank Name
Bank Address
Account Name
Account Number
Transit Number
SWIFT Number
GST Number
AUTHORIZED SIGNATORY
The Authorized Signatory must be either a signatory of the Contract, a person authorized to receive Notices, or the Company Representative.
If not, a Form of Certificate of Incumbency (IESOCM-FORM-18A/Corporation or IESOCM-FORM-18B/General Partner) must be submitted with this form.
By:
Date:
[Name]
[Title]
[Legal Name of Supplier]
FORM OF PAYMENT ACCOUNT INFORMATION
IESOCM-FORM-010(2013-05)
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