Laserfiche WebLink
V1.7_03_2S JC <br />CHECK Signatures for New Accound(s) Addhional Signatures for Roplpca Signatures on Card lot Y <br />ONE : AcCOU.rml a ACC ©and 8 <br />Client NamefAccount Holder. CITY OF SANTA ANA <br />(For Sole Proprietor or Disregarded Entity, <br />intrinsic the name ut the owher. <br />Account Title: <br />CITY OF SANTA ANA <br />Address: <br />20 CIVIC PLZ <br />CITY, State, Zip <br />SANTA ANA.. CA 92701.4e10 USA <br />Account <br />Numberdoc <br />9353099500, 935309377,9353O9427 <br />Telephone Number: <br />(7 14 W-5420 <br />Tax ID Number'. <br />(For Sole Proprietor or. <br />Disregarded Entity, indicate TIN <br />of owner.' 1 <br />9'56000785 <br />INSTRUCTIONS: Uss L� ACK OR t3. LUu ink. (Race lire Manuel or Facsimile at nature wrolino the box boundaries only Do N overlap srgoatures. Indic he if the <br />operators is Manual or a Residents, In the "PRINT NAME" box When providing a F`acslrndPe Signature, provide a Manual Sgnaluse, too. For your seccurity, crosscut all <br />unused e uhnarree boxes before sinning the signature card below, <br />FRANCISCO G't1TIlERREX <br />CPolli FRANCISCO GU'TI'ERREZ. <br />E,'manual CHRGSTINE: C. DU,AR'FF. <br />Dis annual <br />EXEOUTIVE DIRECTOR, FINANCE R <br />MANAGEMENT AGENCY <br />714- 647-5410 <br />FXEC:UTIVE:E. (DIRECTOR, FINANCE X <br />MANA'GEMENTAGENCY <br />TREASURY MANAGER <br />W <br />jr he undaraigined airy Ruiz +oi ced repiesentubve Of the AGnOtrot Holder. fAM,fves 'Met ntrshe ties reviewed the information contained In this Signature Caud. the <br />Cultdficcate Regarding Accounts, andJOr any other account armhoriaantr n dcirob nl and ends it a0ruhh6, on this dater The Account Holder has received and agrees to <br />be sorrier by the devils and Wnr i governirvg, the operation of accounts and arirwuces provided by dPMorean Chase parak, Nalio nar Association, ( "'ilia Banal,'), <br />Includling the Account Te'ms end Service Tiomar„ as they" may he anrenderl or supt'emmened foam inno W time <br />The undersigned is authorized to certify the names, tides, and signatures of aurthardsed signers our IhrdSrOhr, yr, aGoi uniel pursuani: to he GlerirtiCate Regarding <br />Acc'oun'ts tar, if applicable another' account authorization document In st a "Torade resoiralprun, podneesreiln l gei & security n,gi'aennLi-it or a limited liability company' <br />letter & secuhily agneooniant), '1 the undersdpred cerbfafs that due (Na) 2 signatures messit r•d on these binges are time signatures of Farmers authorized to sign and <br />mperwVSe act on behalf of the Account Holder with respor t to his alx;uurit point baukmg fxansac9nns or ser"oes. 'lane pant, n ool died to rely on the ermine; rdty of ore <br />Tax ID Number Certification - Under pensine3 of perjury, I comity that <br />1. The rnumbes shown our this form is iney Corn tawpmfcl Idenufloabon number oar fart waiting fur a number tla be issued to rnep, and <br />Z 1 am not sabpurd to thritkup whhholyddng bacause, (a) I am examnpt tram backup withhori ing, or (b) I have not been portend by the kr erial Revenue 8ewice, yllv,9 <br />that 1 one subJlect to backup Withholding, as maulR Ufa talirare to report an interest or dividends, or (C) the IRS has refined one that I am longer subject to backup <br />Withholding, and <br />3- 1 her a N S CRizen of other U S. person las defiinedl in the IRS Form W-9 Inshuctlons), <br />Certification Instructions. You roust crews out item 2 above df you have loven notified by the IRS that you are currently subject to beckon wilhhordldng because you <br />have felled to report all reveal and dividends on your taw return.. Sen trig IRS Form W -R Insdruahons for additional Information, <br />© The Account Holder is a nonresident often or foreign entity, avid therefore the cartiflCbitph above does not apply. Tine Account. Hurrahs foreign status <br />lies been certified to the Sepik on the appropHat9 Ford$ Willi <br />I The IRS does not require your corp en'f to anp`ylnydglsion cgt,'Ani6 document other than the connotations required to avoid backup withholding. 11 <br />55A -159 <br />