Financial Institution Information Section. Financial institution prints or types the name and address of the payee/company's financial institution who will receive the ACH payment, ACH coordinator name and telephone number, nine-digit routing transit number, depositor (payee/company) account title and account number. Also, the box for type of account is checked, and the signature, title, and telephone number of the appropriate financial institution official are included.
Financial Institution Information Section. Financial institution prints or types the name and address of the payee/company's financial institution who will receive the ACH payment, ACH coordinator name and telephone number, nine-digit routing transit number, depositor (payee/company) account title and account number. Also, the box for type of account is checked, and the signature, title, and telephone number of the appropriate financial institution official are included. Burden Estimate Statement The estimated average burden associated with this collection of information is 15 minutes per respondent or recordkeeper, depending on individual circumstances. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed to the Financial Management Service, Facilities Management Division, Property and Supply Branch, Xxxx X-000, 0000 Xxxx Xxxx Xxxxxxx, Xxxxxxxxxxx, XX 00000 and the Office of Management and Budget, Paperwork Reduction Project (1510-0056), Xxxxxxxxxx, XX 00000. PROJECT PLAN FOR THE FY 2012 COMMERCIAL VEHICLE INFORMATION SYSTEMS AND NETWORKS (CVISN) DEPLOYMENT GRANT PROGRAM EXPANDED CVISN Date _Dec. 5, 0000 Xxxxx Xxxxxxx Xxxxx CVISN Program Manager Name Telephone E-mail Address Xxxx Xxxxx (000) 000-0000 xxxx.xxxxx@xxx.xxxxx.xx.xx State CVISN System Architect Name Telephone E-mail Address Xxxxxxx Xxxxxx (000) 000-0000 xxxxxxx@x-xxxxxxx.xxx State Point of Contact for FY 2012 Expanded CVISN Project Plan (this document) Name Telephone E-mail Address Xxxx Xxxxx (000) 000-0000 xxxx.xxxxx@xxx.xxxxx.xx.xx Signing date for the interagency Memorandum of Understanding (MOU) between the state’s CVISN agencies (please state if only one agency is involved in CVISN) Date May 25, 2000 Date of approval and title of the Expanded CVISN Program Plan/Top-Level Design Date February 1, 2010 Title Expanded CVISN Program Plan and Top-Level Design For the State of Florida Date of letter that certified the State as Core CVISN Certified (please attach the core certification letter to the application) Date February 24, 2009_ Instructions to Preparer This template includes: • Numbered chapters containing the required textual information and graphics. • Project chapter templates. • Blank tables for the required tabular elements. • Imbedded instructions. Note: For each project, the State must include a chapter (e.g., Chapters 2, 3, … through n in the State’s Fiscal Year (FY) 2012 Expanded CVISN Project Plan) that provides all relevant information for the proposed proje...
Financial Institution Information Section. Financial institution prints or types the name and address of the payee/company's financial institution who will receive the ACH payment, ACH coordinator name and telephone number, nine-digit routing transit number, depositor (payee/company) account title and account number. Also, the box for type of account is checked, and the signature, title, and telephone number of the appropriate financial institution official are included. Burden Estimate Statement The estimated average burden associated with this collection of information is 15 minutes per respondent or recordkeeper, depending on individual circumstances. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed to the Financial Management Service, Facilities Management Division, Property and Supply Branch, Room B-000, 0000 Xxxx Xxxx Xxxxxxx, Xxxxxxxxxxx, XX 00000 and the Office of Management and Budget, Paperwork Reduction Project (1510-0056), Washington, DC 20503. [Agency Partner Name] – Project Summary [CESU Name] Cooperative Ecosystem Studies Unit Agreement Modification Form FUNDING AGENCY: SUB-AGREEMENT/MODIFICATION NUMBER: [CESU USE ONLY] COOPERATIVE AGREEMENT NUMBER: FUNDING AMOUNT: PROJECT TITLE: EFFECTIVE PROJECT DATES: PROJECT PURPOSE: STATEMENT OF MUTUAL BENEFIT AND INTEREST: Key Words: Federal Agency Contact(s) and Signature(s) Partner Signature(s) [Agency] Project Technical Representative & Project Leader: Technical Rep: Address: Phone: Fax: Email: Project Leader: Phone: Email: No Signature Needed [Agency] Administrator: Signature: Date: Principal Investigator: Signature: Date: Agreement / Grant Administrator: Signature: Date: Project Type: Research Technical Assistance Education Project Discipline(s): Biological Cultural Physical Social Interdisciplinary Annual Performance Report Required: Report(s) Received: Publications on File:
