THE NEW YORK CITY COMPTROLLER’S OFFICE
BUREAU OF ACCOUNTANCYBANK RECONCILATION DIVISION AGENCY BANK ACCOUNT INFORMATIONFY ENDING 20 FORMTEXT FYAGENCY NAME FORMTEXT FILL IN NAME AGENCY CODE NO. FORMTEXT LIST AGENCY CODENAME OF BANK FORMTEXT ENTER BANK NAMEACCOUNT NUMBER FORMTEXT ENTER BANK ACCT NOTYPE OF BANK ACCOUNT FORMCHECKBOX SAVINGS FORMCHECKBOX MONEY MARKET FORMCHECKBOX CHECKING: INTEREST-BEARING FORMCHECKBOX YES FORMCHECKBOX NOHOW LONG ESTABLISHED (PLEASE CHECK ONE): FORMCHECKBOX 1 TO 5 YEARS FORMCHECKBOX OVER 5 YEARSPURPOSE OF ACCOUNT: FORMTEXT ?????APPROXIMATE RECEIPTS: FORMTEXT ENTER $ AMOUNT OF RECEIPTSAPPROXIMATE DISBURSEMENTS: FORMTEXT ENTER $ AMOUNT OF DISBURSEMENTSAPPROXIMATE INTEREST EARNED: FORMTEXT ENTER $ AMOUNT OF INTEREST EARNEDSOURCE OF FUNDING: FORMCHECKBOX FMS ACCOUNTING PAYMENT REQUEST FORMCHECKBOX OTHER (PLEASE EXPLAIN): FORMTEXT ?????APPROXIMATE NUMBER OF CHECKS ISSUED PER YEAR FORMTEXT ENTER # OF CHECKS FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????NAMETITLETELEPHONE NUMBERDATE ................
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