Elders Monthly Supplement Form for Members of Peerless Trout First Nation
PTFN Trust – Elders Monthly Supplement Form
Name of Applicant:
Treaty Number:
Mailing Address:
Date of Birth:_____________________________________________
(Proof of age & PTFN Membership to be verified with PTFN membership)
Please choose one of the following for payment:
- I prefer to have my Supplement direct deposited; I have attached my banking info
- I prefer to have my Supplement made out in Cheque.
- I prefer to have my Supplement deposited in a third-party account (ie: family) (please attached the third-party consent form)
Please attach a void cheque to have the funds deposited to your bank account. Please return form by the following methods: drop off at the PTFN Trust Department or emailing to esther.netowastanum@ptfn.net. Payments are subject to staff processing availability, please allow time for processing. If you would like your benefit deposited in a third- party bank account (ie. Family) please submit consent form. Each eligible member will receive $150/month. For more information, please call 780-649-5887.