Hoffmann-La Roche Limited/Limitee (Roche Canada)
Vendor Electronic Funds Transfer (EFT) Request   [Fran├žais]


VENDOR OR/PAYEE INFORMATION:
Business/Trade Name:
Payee Name:
Postal Code:
Vendor #: 903
Telephone Number:
Email Address for remittance advice:


BANK ACCOUNT INFORMATION (Please attach a void cheque or bank confirmation)

To ensure accuracy and avoid payment delays, you must upload a copy of a void cheque or a bank confirmation here.
   Max. file size 5Mb   

Approver's Name:
Title:
Email:
Phone:
Date:   March 21, 2019
Any questions you may have, please send to the confidential email:   mississauga.vendor_reqts@roche.com