User Name means any user name allocated to the Customer for access to the Services;
Company Name Address: Attention: Tel: Fax: Email: For all correspondence except payments – Center for Technology Licensing at Cornell University Attention: Executive Director ▇▇▇ ▇▇▇▇ ▇▇▇▇ ▇▇▇▇, ▇▇▇▇▇ ▇▇▇ ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ FAX: ▇▇▇-▇▇▇-▇▇▇▇ TEL: ▇▇▇-▇▇▇-▇▇▇▇ EMAIL: ▇▇▇-▇▇▇▇▇▇▇▇▇@▇▇▇▇▇▇▇.▇▇▇ Center for Technology Licensing at Cornell University ▇▇ ▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇ Receiving bank name: ▇▇▇▇▇▇▇▇ Trust Co. Bank account no.: 0111000065 Bank routing (ABA) no.: ▇▇▇▇▇▇▇▇▇ SWIFT code: Bank account name: ▇▇▇▇▇▇▇▇ Cornell University Bank ACH format code: Not required Bank address: ▇.▇. ▇▇▇, ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ Additional information: Reference D-4730 Agreement No.: <to be assigned> An email copy of the transaction receipt shall be sent to ▇▇▇-▇▇▇▇▇▇▇▇▇@▇▇▇▇▇▇▇.▇▇▇. Licensee is responsible for all bank charges of wire transfer of funds for payments. The bank charges shall not be deducted from the total amount due to Cornell.
s Name Property Address: _________________________________________________________
Property Name Property Address: Control No.: The Mortgage File should be delivered to the following: ________________________________________ ________________________________________ ________________________________________
Contact Name Date: Address: Phone: City: State: Zip Code: Email: