Request to Change an Authorized Check Signer(s) or Signing ...
Request to Change an Authorized Check Signer(s) or Signing Limits
Department Name/Location:________________________________________________
Bank Name: ________________________________________________________
Bank Account Title: ______________________________________________________
Bank Account Number: ___________________________________________________
Departmental Contact: ____________________________________________________
Contact’s Phone Number: ___________________E-Mail _________________________
Current Bank Account Signatory(ies:) ________________________________________
_________________________________________
_________________________________________
Remove Bank Account Signatory(ies):________________________________________
_________________________________________
_________________________________________
Add Bank Account Signatory(ies): _________________________________________
_________________________________________
_________________________________________
G/L Account Number(s): _________________________________________
Signers attest to:
• The individual(s) being removed as signer(s) is (are) appropriate.
• The individual(s) being added are the appropriate individual(s) in the unit to perform this function.
• The limits requested are reasonable.
• That this (these) individual(s) will not be involved in the reconciliation of the account.
• Notification will be remitted to the Treasurer’s Office immediately if there is a change in signature designees.
Unit Head:
Name: _____________________________________________
Signature: _____________________________________________
Unit Business Administrator:
Name: _____________________________________________
Signature: _____________________________________________
Please note: Departmental signing levels do not exceed $50,000.00 U.S. or the University established international currency equivalents. Authorization for these individuals is approved by the University’s Executive Vice President for Finance and CFO.
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