Payment of fees - Commission des transports du Québec
Transcription
Payment of fees - Commission des transports du Québec
Payment of fees The information provided on this form is confidential and will be used exclusively to process the fees applicable to your application. CTQ use only IMPORTANT Numéro de demande : The possible methods of payment are: direct payment or cash (at the counter only, credit card, personal cheque or money order (payable to the Minister of Finance). Numéro de revenu : Complete this form only for credit card payment. Date : Vérifié par : 1 – Details of payment Visa Master Card American Express Expiration date Credit card number Month Year RIN or file number (if available) Amount paid 2 – Signature Signature Name (in block letters) Year Month Day Submit your application Send the signed form along with the payment and the required documents: By secure email www.ctq.gouv.qc.ca/en/to_reach_us By fax 514 873-4720 or 418 644-8034 Commission des transports du Québec e 200, chemin Sainte-Foy, 7 étage Québec (Québec) G1R 5V5 By mail In person 545, boulevard Crémazie Est e 10 étage, Bureau 1000, Montréal e 200, chemin Sainte-Foy, 7 étage Québec To reach us Internet address www.ctq.gouv.qc.ca By phone Montreal area: 514 873-6424 All other areas: 1 888 461-2433 Commission des transports du Québec CTQ-317A (2016-05)