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2022-10-12_sdaoust_Client Remittance Change Request_EN.docx

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The undersigned hereby agrees to the above and certifies the accuracy of the information provided above as at the date shown below, and acknowledges that Ceridian Canada Ltd. (and / or its Affiliates) will be relying on same in providing services to the undersigned.

Account # | PPG4082 | Case # | 03132673

CLIENT SET-UP INFORMATION FORM
ONE FORM REQUIRED PER PAYROLL / PAY GROUP | CLIENT SET-UP INFORMATION FORM
ONE FORM REQUIRED PER PAYROLL / PAY GROUP | CLIENT SET-UP INFORMATION FORM
ONE FORM REQUIRED PER PAYROLL / PAY GROUP | CLIENT SET-UP INFORMATION FORM
ONE FORM REQUIRED PER PAYROLL / PAY GROUP | CLIENT SET-UP INFORMATION FORM
ONE FORM REQUIRED PER PAYROLL / PAY GROUP | CLIENT SET-UP INFORMATION FORM
ONE FORM REQUIRED PER PAYROLL / PAY GROUP | CLIENT SET-UP INFORMATION FORM
ONE FORM REQUIRED PER PAYROLL / PAY GROUP

All information on this page is the same as payroll / pay group ID                                   EXCEPT as noted below | All information on this page is the same as payroll / pay group ID                                   EXCEPT as noted below | All information on this page is the same as payroll / pay group ID                                   EXCEPT as noted below | All information on this page is the same as payroll / pay group ID                                   EXCEPT as noted below | All information on this page is the same as payroll / pay group ID                                   EXCEPT as noted below | All information on this page is the same as payroll / pay group ID                                   EXCEPT as noted below

CLIENT INFORMATION | CLIENT INFORMATION | CLIENT INFORMATION | CLIENT INFORMATION | CLIENT INFORMATION | CLIENT INFORMATION | CLIENT INFORMATION | CLIENT INFORMATION

Client Name (full legal name): | Client Name (full legal name): | Client Name (full legal name): | Client Name (full legal name): | Client Name (full legal name): | Client Name (full legal name): | Client Name (full legal name): | Client Name (full legal name):

Trade / Operating Name (if different than full legal name): | Trade / Operating Name (if different than full legal name): | Trade / Operating Name (if different than full legal name): | Trade / Operating Name (if different than full legal name): | Trade / Operating Name (if different than full legal name): | Trade / Operating Name (if different than full legal name): | Trade / Operating Name (if different than full legal name): | Trade / Operating Name (if different than full legal name):

Delivery Address for Payroll (if different than address in Order Form): | Delivery Address for Payroll (if different than address in Order Form): | Delivery Address for Payroll (if different than address in Order Form): | Delivery Address for Payroll (if different than address in Order Form): | Delivery Address for Payroll (if different than address in Order Form): | Delivery Address for Payroll (if different than address in Order Form): | Delivery Address for Payroll (if different than address in Order Form): | Delivery Address for Payroll (if different than address in Order Form):

Street Address | Street Address | Street Address | Street Address | City | Province | Postal Code | Postal Code

Contact for “Stop Payments” & “EFT Rejections” (if different than Service Contact in Order Form): | Contact for “Stop Payments” & “EFT Rejections” (if different than Service Contact in Order Form): | Contact for “Stop Payments” & “EFT Rejections” (if different than Service Contact in Order Form): | Contact for “Stop Payments” & “EFT Rejections” (if different than Service Contact in Order Form): | Contact for “Stop Payments” & “EFT Rejections” (if different than Service Contact in Order Form): | Contact for “Stop Payments” & “EFT Rejections” (if different than Service Contact in Order Form): | Contact for “Stop Payments” & “EFT Rejections” (if different than Service Contact in Order Form): | Contact for “Stop Payments” & “EFT Rejections” (if different than Service Contact in Order Form):

Contact Name | Contact Name | Contact Name | Contact Name | E-mail Address | E-mail Address | E-mail Address | E-mail Address

First Payroll Input/Live Date: | First Payroll Input/Live Date: | First Payroll Input/Live Date: | Cheque/Payment Date: | Pay Period Ending Date: | Pay Period Ending Date: | Pay Period Ending Date: | Pay Period Ending Date:

CLIENT REMITTANCE INFORMATION	Ceridian Canada Ltd. to collect / remit statutory remittances?   Yes   No | CLIENT REMITTANCE INFORMATION	Ceridian Canada Ltd. to collect / remit statutory remittances?   Yes   No | CLIENT REMITTANCE INFORMATION	Ceridian Canada Ltd. to collect / remit statutory remittances?   Yes   No | CLIENT REMITTANCE INFORMATION	Ceridian Canada Ltd. to collect / remit statutory remittances?   Yes   No | CLIENT REMITTANCE INFORMATION	Ceridian Canada Ltd. to collect / remit statutory remittances?   Yes   No | CLIENT REMITTANCE INFORMATION	Ceridian Canada Ltd. to collect / remit statutory remittances?   Yes   No | CLIENT REMITTANCE INFORMATION	Ceridian Canada Ltd. to collect / remit statutory remittances?   Yes   No | CLIENT REMITTANCE INFORMATION	Ceridian Canada Ltd. to collect / remit statutory remittances?   Yes   No

Federal
CRA Business Number                                            	RP                      EI Rate    .               
	RP                      EI Rate    .               
	RP                      EI Rate    .               
CRA Remittance Frequency:
 Quarterly	 Once/month	 Semi-monthly	 Accelerated (3 days following remit period end)
	(Regular)	(Threshold 1)	(Threshold 2) | Federal
CRA Business Number                                            	RP                      EI Rate    .               
	RP                      EI Rate    .               
	RP                      EI Rate    .               
CRA Remittance Frequency:
 Quarterly	 Once/month	 Semi-monthly	 Accelerated (3 days following remit period end)
	(Regular)	(Threshold 1)	(Threshold 2) | Federal
CRA Business Number                                            	RP                      EI Rate    .               
	RP                      EI Rate    .               
	RP                      EI Rate    .               
CRA Remittance Frequency:
 Quarterly	 Once/month	 Semi-monthly	 Accelerated (3 days following remit period end)
	(Regular)	(Threshold 1)	(Threshold 2) | Federal
CRA Business Number                                            	RP                      EI Rate    .               
	RP                      EI Rate    .               
	RP                      EI Rate    .               
CRA Remittance Frequency:
 Quarterly	 Once/month	 Semi-monthly	 Accelerated (3 days following remit period end)
	(Regular)	(Threshold 1)	(Threshold 2) | Federal
CRA Business Number                                            	RP                      EI Rate    .               
	RP                      EI Rate    .               
	RP                      EI Rate    .               
CRA Remittance Frequency:
 Quarterly	 Once/month	 Semi-monthly	 Accelerated (3 days following remit period end)
	(Regular)	(Threshold 1)	(Threshold 2) | Federal
CRA Business Number                                            	RP                      EI Rate    .               
	RP                      EI Rate    .               
	RP                      EI Rate    .               
CRA Remittance Frequency:
 Quarterly	 Once/month	 Semi-monthly	 Accelerated (3 days following remit period end)
	(Regular)	(Threshold 1)	(Threshold 2) | Federal
CRA Business Number                                            	RP                      EI Rate    .               
	RP                      EI Rate    .               
	RP                      EI Rate    .               
CRA Remittance Frequency:
 Quarterly	 Once/month	 Semi-monthly	 Accelerated (3 days following remit period end)
	(Regular)	(Threshold 1)	(Threshold 2) | Federal
CRA Business Number                                            	RP                      EI Rate    .               
	RP                      EI Rate    .               
	RP                      EI Rate    .               
CRA Remittance Frequency:
 Quarterly	 Once/month	 Semi-monthly	 Accelerated (3 days following remit period end)
	(Regular)	(Threshold 1)	(Threshold 2)

Quebec (mandatory if a Quebec registrant)
 Quebec Tax No.                                                   RS                      Total Worldwide Payroll Amount $       
Remittance Frequency: 	 Quarterly	 Once/month	 Twice/month	 Weekly
 CNESST:   Primary Rate:       %	Additional Rate(s):       %,       %,       %
Please select one of the following CNESST options:     Calculate Only	   Calculate and Remit | Quebec (mandatory if a Quebec registrant)
 Quebec Tax No.                                                   RS                      Total Worldwide Payroll Amount $       
Remittance Frequency: 	 Quarterly	 Once/month	 Twice/month	 Weekly
 CNESST:   Primary Rate:       %	Additional Rate(s):       %,       %,       %
Please select one of the following CNESST options:     Calculate Only	   Calculate and Remit | Quebec (mandatory if a Quebec registrant)
 Quebec Tax No.                                                   RS                      Total Worldwide Payroll Amount $       
Remittance Frequency: 	 Quarterly	 Once/month	 Twice/month	 Weekly
 CNESST:   Primary Rate:       %	Additional Rate(s):       %,       %,       %
Please select one of the following CNESST options:     Calculate Only	   Calculate and Remit | Quebec (mandatory if a Quebec registrant)
 Quebec Tax No.                                                   RS                      Total Worldwide Payroll Amount $       
Remittance Frequency: 	 Quarterly	 Once/month	 Twice/month	 Weekly
 CNESST:   Primary Rate:       %	Additional Rate(s):       %,       %,       %
Please select one of the following CNESST options:     Calculate Only	   Calculate and Remit | Quebec (mandatory if a Quebec registrant)
 Quebec Tax No.                                                   RS                      Total Worldwide Payroll Amount $       
Remittance Frequency: 	 Quarterly	 Once/month	 Twice/month	 Weekly
 CNESST:   Primary Rate:       %	Additional Rate(s):       %,       %,       %
Please select one of the following CNESST options:     Calculate Only	   Calculate and Remit | Quebec (mandatory if a Quebec registrant)
 Quebec Tax No.                                                   RS                      Total Worldwide Payroll Amount $       
Remittance Frequency: 	 Quarterly	 Once/month	 Twice/month	 Weekly
 CNESST:   Primary Rate:       %	Additional Rate(s):       %,       %,       %
Please select one of the following CNESST options:     Calculate Only	   Calculate and Remit | Quebec (mandatory if a Quebec registrant)
 Quebec Tax No.                                                   RS                      Total Worldwide Payroll Amount $       
Remittance Frequency: 	 Quarterly	 Once/month	 Twice/month	 Weekly
 CNESST:   Primary Rate:       %	Additional Rate(s):       %,       %,       %
Please select one of the following CNESST options:     Calculate Only	   Calculate and Remit | Quebec (mandatory if a Quebec registrant)
 Quebec Tax No.                                                   RS                      Total Worldwide Payroll Amount $       
Remittance Frequency: 	 Quarterly	 Once/month	 Twice/month	 Weekly
 CNESST:   Primary Rate:       %	Additional Rate(s):       %,       %,       %
Please select one of the following CNESST options:     Calculate Only	   Calculate and Remit

Other Provincial / Territorial Remittance Information (mark and complete only jurisdictions where Employees are located and remittances / filings due) | Other Provincial / Territorial Remittance Information (mark and complete only jurisdictions where Employees are located and remittances / filings due) | Other Provincial / Territorial Remittance Information (mark and complete only jurisdictions where Employees are located and remittances / filings due) | Other Provincial / Territorial Remittance Information (mark and complete only jurisdictions where Employees are located and remittances / filings due) | Other Provincial / Territorial Remittance Information (mark and complete only jurisdictions where Employees are located and remittances / filings due) | Other Provincial / Territorial Remittance Information (mark and complete only jurisdictions where Employees are located and remittances / filings due) | Other Provincial / Territorial Remittance Information (mark and complete only jurisdictions where Employees are located and remittances / filings due) | Other Provincial / Territorial Remittance Information (mark and complete only jurisdictions where Employees are located and remittances / filings due)

Manitoba 	Health & Education Tax No.                                                MT                     Regular       Notched | Manitoba 	Health & Education Tax No.                                                MT                     Regular       Notched | Manitoba 	Health & Education Tax No.                                                MT                     Regular       Notched | Manitoba 	Health & Education Tax No.                                                MT                     Regular       Notched | Manitoba 	Health & Education Tax No.                                                MT                     Regular       Notched | Manitoba 	Health & Education Tax No.                                                MT                     Regular       Notched | Manitoba 	Health & Education Tax No.                                                MT                     Regular       Notched | Manitoba 	Health & Education Tax No.                                                MT                     Regular       Notched

Newfoundland & Labrador	HAPSET Tax No.                                Oracle # | Newfoundland & Labrador	HAPSET Tax No.                                Oracle # | Newfoundland & Labrador	HAPSET Tax No.                                Oracle # | Newfoundland & Labrador	HAPSET Tax No.                                Oracle # | Newfoundland & Labrador	HAPSET Tax No.                                Oracle # | Newfoundland & Labrador	HAPSET Tax No.                                Oracle # | Newfoundland & Labrador	HAPSET Tax No.                                Oracle # | Newfoundland & Labrador	HAPSET Tax No.                                Oracle #

North West Territories 	Payroll Tax No. | North West Territories 	Payroll Tax No. | North West Territories 	Payroll Tax No. | North West Territories 	Payroll Tax No. | North West Territories 	Payroll Tax No. | North West Territories 	Payroll Tax No. | North West Territories 	Payroll Tax No. | North West Territories 	Payroll Tax No.

Nova Scotia 	WCB Tax No.                                               NW                      Primary Rate                 
            NW                      Additional Rate | Nova Scotia 	WCB Tax No.                                               NW                      Primary Rate                 
            NW                      Additional Rate | Nova Scotia 	WCB Tax No.                                               NW                      Primary Rate                 
            NW                      Additional Rate | Nova Scotia 	WCB Tax No.                                               NW                      Primary Rate                 
            NW                      Additional Rate | Nova Scotia 	WCB Tax No.                                               NW                      Primary Rate                 
            NW                      Additional Rate | Nova Scotia 	WCB Tax No.                                               NW                      Primary Rate                 
            NW                      Additional Rate | Nova Scotia 	WCB Tax No.                                               NW                      Primary Rate                 
            NW                      Additional Rate | Nova Scotia 	WCB Tax No.                                               NW                      Primary Rate                 
            NW                      Additional Rate

Nunavut 	Payroll Tax No. | Nunavut 	Payroll Tax No. | Nunavut 	Payroll Tax No. | Nunavut 	Payroll Tax No. | Nunavut 	Payroll Tax No. | Nunavut 	Payroll Tax No. | Nunavut 	Payroll Tax No. | Nunavut 	Payroll Tax No.

Ontario	Employer Health Tax (EHT) No                                                TE                   
	Rate                    	Exemption $      	Remittance Frequency:	 Annually	 Monthly | Ontario	Employer Health Tax (EHT) No                                                TE                   
	Rate                    	Exemption $      	Remittance Frequency:	 Annually	 Monthly | Ontario	Employer Health Tax (EHT) No                                                TE                   
	Rate                    	Exemption $      	Remittance Frequency:	 Annually	 Monthly | Ontario	Employer Health Tax (EHT) No                                                TE                   
	Rate                    	Exemption $      	Remittance Frequency:	 Annually	 Monthly | Ontario	Employer Health Tax (EHT) No                                                TE                   
	Rate                    	Exemption $      	Remittance Frequency:	 Annually	 Monthly | Ontario	Employer Health Tax (EHT) No                                                TE                   
	Rate                    	Exemption $      	Remittance Frequency:	 Annually	 Monthly | Ontario	Employer Health Tax (EHT) No                                                TE                   
	Rate                    	Exemption $      	Remittance Frequency:	 Annually	 Monthly | Ontario	Employer Health Tax (EHT) No                                                TE                   
	Rate                    	Exemption $      	Remittance Frequency:	 Annually	 Monthly

Alberta	 British Columbia	 New Brunswick	 Prince Edward Island	 Saskatchewan	 Yukon | Alberta	 British Columbia	 New Brunswick	 Prince Edward Island	 Saskatchewan	 Yukon | Alberta	 British Columbia	 New Brunswick	 Prince Edward Island	 Saskatchewan	 Yukon | Alberta	 British Columbia	 New Brunswick	 Prince Edward Island	 Saskatchewan	 Yukon | Alberta	 British Columbia	 New Brunswick	 Prince Edward Island	 Saskatchewan	 Yukon | Alberta	 British Columbia	 New Brunswick	 Prince Edward Island	 Saskatchewan	 Yukon | Alberta	 British Columbia	 New Brunswick	 Prince Edward Island	 Saskatchewan	 Yukon | Alberta	 British Columbia	 New Brunswick	 Prince Edward Island	 Saskatchewan	 Yukon

Client Name:

Per:

(Signature)

Name of Signatory:

Title:

Date:

I have the authority to bind the corporation.