Please attach a definition

Please attach a. VOIDED CHECK TO THE BOTTOM OF THIS AUTHORIZATION FORM

Please attach a. VOIDED CHECK (with preprinted name and address) FROM THE CHECKING ACCOUNT THAT WILL BE CHARGED. MAIL THIS FORM TO: THE MANAGEMENT TRUST - NORTHWEST PO BOX 23099

Please attach a voided check if Union Building Trades FCU is debiting your checking account.

Examples of Please attach a in a sentence

• Name: Name: Phone: Phone: Adults NOT Authorized to Take Youth to and From Events: Name: Name: Phone: Phone: Age: Gender: Height (inches): Weight (lbs.): Address: City: State: ZIP code: Phone: Unit leader: Unit leader’s mobile #: Council Name/No.: Unit No.: Health/Accident Insurance Company: Policy No.: Please attach a photocopy of both sides of the insurance card.

• Please attach a description and status of major supplier items in terms of lead times related to key project components as Appendix D.3 to this report.

• Updates With Respect to Expenditures on Community Benefit Funds, Grants, Apprenticeships and Internships, Educational Cooperative Efforts, and/or Training Initiatives Please attach a list of dollars per quarter spent (not budgeted or allocated) in pursuit of community benefit funds, grants, apprenticeship and internships, educational cooperative efforts, or training as Appendix F.1 to this report.

• US Revenue Non-US Revenue Total Most Recent Twelve months: (ending: ) USD: - USD: USD: Previous Year Next Year (estimate) USD: USD: USD: USD: USD: USD: Please attach a copy of your most recently audited annual financial statement.

• Please attach a summary of communication efforts and outcomes for all opportunities for contracts with an anticipated contract value of $1 million or greater to the New York State Supplier Database, as Appendix D.4 to this report.

• Please attach a list of upcoming activities, tenders and/or supplier/buyer engagements related to New York State supplier opportunity as Appendix D.2 to this report.

• Please attach a list of completed meetings, outreach activities, and outcomes including Consultations with New York State Agencies and Technical Working Group (TWG) Participation for the previous quarter including outcomes as Appendix G.2 to this report.

• No. of attendees Name of Company providing units: Contact Number: Number of units: Number of handwashing stations: Location where units will be located: (show on map) When will units be delivered: And: removed: Please attach a detailed site plan of the Event/Activity if applicable.

• Please attach a list of hosted Supplier Forums for New York State firms including proof of planning activities, event venues, date selection and attendance as Appendix D.6 to this report.

• The Status of Specific Industry Growth Activities Including Industry Event Dates and Attendees, Negotiating of Contracts, Establishment of Facilities, Steering Members and Board Members, Supply Chain Investments, Hiring of Employees, Establishment of Funds, Dollars Spent, Submitted and Awarded Proposals, Launch Dates, and Workers Trained Please attach a summary related to the specific industry growth activities committed to the project as Appendix E.1 to this report.

More Definitions of Please attach a

Please attach a. “VOIDED” check or deposit slip.

Please attach a. VOIDED check…NOT a deposit slip! I hereby authorize the City of Parma to initiate credit entries and to initiate, if necessary, debit entries and adjustments for any credit entries in error to my Please check one : □ checking account or □ savings account indicated below and the BANK name listed below, to credit and/or debit the same to such account. NET Bank #1 Name Account # Bank (This would be your net check, after all other direct deposits and deductions.) Bank #2 Name Account Number Bank (This must be for a specific $ amount.) □ checking account or □ savings account $$ amount Bank #3 Name Account Number Bank (This must be for a specific $ amount.) □ checking account or □ savings account $$ amount Bank #4 Name Account Number Bank (This must be for a specific $ amount.) □ checking account or □ savings account $$ amount Bank #5 Name Account Number Bank (This must be for a specific $ amount.) □ checking account or □ savings account $$ amount Bank #6 Name Account Number Bank (This must be for a specific $ amount.) □ checking account or □ savings account $$ amount This authority is to remain in full force and effect until the City of Parma has received written notification from me of its termination in such time and in such manner as to afford the City of Parma and the Bank a reasonable opportunity to act on it. Signature Date Your direct deposit will begin with the first available payroll following verification of all information. **To direct deposit to PSE Credit Union or Fire Fighters Community Credit Union, you MUST also complete the application form from the respective Credit Union and return both forms to Payroll. --------------------------------------------------------------------------------------------------------------------------------------- Payroll Department Use Only

Please attach a voided check (voided withdrawal slip may be used with savings accounts.) Frequency: Every . 1 . 3 . 6 . 12

Please attach a. COPY OF YOUR FIRM'S RESUME AND ANY CURRENT MARKETING MATERIALS.

Please attach a. VOIDED check if you are using your checking account. If you are using your savings account please include a VOIDED savings withdrawal slip that includes the NINE digit routing number. If it is not printed on the withdrawal slip, ask your bank for the routing number. If you change or close your account that you have listed above, PLEASE notify us in advance to avoid a return charge. Name Customer Account # Address Date Signed Customer Signature Please return this and the requested VOIDED form to : Roaming Shores Utility 0000 Xxxxxxx Xxxx PO Box 237

Please attach a voided check to the bottom of this form and return it in the enclosed return envelope. A sample of a voided check is included below for reference. Name Address City, State, ZIP