***Please note that our offices will be closed on Tuesday, December 25, 2018 and Wednesday, December 26, 2018 for the statutory holidays. Online remittance forms will be processed on December 26. We will be back to regular business hours on Thursday, December 27, 2018***
Cost Efficient Benefit Plan
(Div. of Paloma Ventures Ltd.)
Mailing Address: 234, 5149 Country Hills Blvd. NW, Ste. 513, Calgary, Alberta T3A 5K8
Phone: 403-282-3776 Fax: 403-202-5046 Toll Free: 1-800-651-3776
Office Location: 216, 3907 - 3A Street NE, Calgary, AB (Do not mail to this address)
Website: www.costplus.ca Email: info@costplus.ca
Remittance Form
* The six fields with red asterisks are required.
Date: * (mmm dd, yyyy) ------------------------
Firm Name: * ------------------------
Employee Name: * Phone No.:
Your email address:
I have a new address: ------------------------
City: Province:*
Postal Code:
Claims submitted via this form constitutes consent to continue to contact you/your business by email.
List Current Claims Note: Eligible receipts must be submitted to support your claim
Description of ExpensesAmount
Total Current Claim: *
Administration Fee (5%):
GST/HST:
Total Payable: Make cheques payable to Cost Efficient Benefit Plan
  Attach Receipts     (max files=5; max size=8MB (8000kb))
Click browse to attach a file. Up to five files can be attached. Each file can be up to 8MB in size.
Please make reimbursement payable to: *
Employee:
OR
Firm:
   
If you are mailing in your claim, return this completed form, together with all receipts and your payment to:  
Cost Efficient Benefit Plan
234, 5149 Country Hills Blvd. NW, Ste. 513 Calgary, Alberta T3A 5K8