01/18/94 - Laserfiche WebLink

Home

I. BASIC INFORMATION FORM B 4M Fund REGISTRATION FORM Name of City, Count),, Town, Public Authority, Public Corporation, Public Commission, Special District, or Instrumentalig, (hereinafter the municipality"). Name of Account ~.~_ ~ of Ramses, Name ofMm~icipality. Ci'c.v of Ramse,y Street l{ov.%hen Bou]evard Address =~ 5153 Nowthen Boulevard N.W. City/Zip Ramsev, Minne sots Attention Finance Officer Telephone Number ( 612 )~ ~,- lZ!O Federal Identification Number Zl-OglOz67 II. WITHDRAWAL INFORMATION AND AUTHOPdZATtON Authorization is hereby given for the Fund to honor any request, believed by it to be authentic, for the withdrawal, in whole or in part, of the monies o£the municipality from the Fund. Unless withdrawn by means of the check writing privilege afforded to Participants of the Fund, monies of the municipality withdrawn from the Fund shall be wire transferred by the Fund only to the bank account of the municipality listed below: Bank Name ='~,-~- ~ ~.,~ Account Number 1-)£5-5000-229" Bank Address 12! East Main Street. ~moka. Minnesota 55~O3 III. CHECK WRITING OPTION The municipality wishes to use the optional check writing Service: Yes(~ (circle one) If yes, the number of Fund account checks initially required for use by the municipality is: ~ 250, ~ 500, ~ Other (please fill in amount.) Number ofsignatutres required on each check is ~ Please check here if your municipality wot,Id like a specification sheet for computerized checks. (Please allow 2 weeks for deliver), of your free checks.) IV.. INFORMATION STATEMENT AND DECLARATION OF TRUST It is hereby certified that the municipality has received a copy of the Information Statement of the Fund and the Declaration of Trust creating the Fund, and agrees to be bound by the terms of such documents.