Bank Account Request Form (word) - University at Buffalo
|[pic] |
|Campus Bank Account Request/Change Form |
|New Account |Increase Funds |Decrease Funds |Signature Change |Notification of Account Closeout |
|[pic] |[pic] |[pic] |[pic] |Please include copy of final bank statement[pic] |
|Research Foundation Account Information | |
|Project |Task |Award |Project Director |
|Mailing address for statements |Bank name and branch mailing address |
| | |
| | |
| | |
| | |
|Requested bank account |From |To |Funding limit/increase/decrease for the bank account: |
|period | | |$ |
|Purpose of the account |
| |
| |
|Administrative Information |
|Authorized account signatories |Name |Title |
| | | |
| | | |
| | | |
| | | |
| |
| |Name |Title |
|Monthly reconciliation of the account will be| | |
|performed by | | |
|Blank checks for the account will be held by | | |
|Deposits to the account will be made by | | |
|Operations Manager Signature | | |
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