HomeMy WebLinkAboutArts & Sciences Center CM RetainageORIGINALS REQUIRED *REQUIRED FIELDS TEX - BANK
TexPool Participant Services • Lehman Brothers
600 Travis St., Suite 7200 • Houston, TX 77002 •www.texpool.com
Phone 1-866-839-7665 • Fax 1-866-839-3291
9/06
BANK INFORMATION SHEET
*EFFECTIVE DATE: ______________________________
Please check all that apply.
Add new account Wire and ACH ***Participant Name
Primary***
Add new Banking
Instructions Wire Only
*Street Address
Primary***
Change Banking
Instructions ACH Only**
*Mailing Address
Primary***
Delete Banking
Instructions
*City*State*Zip*County
*Location *Primary Representative
Account Number*Phone*Fax
*Account Name Email
_______ By initialing here I acknowledge that I have chosen TexPool - Prime and understand that it invests in commercial paper. I realize that
this is consistent with my investment policy.
INSTRUCTIONS
*Bank Name
*Bank Address
*City *Texas Zip*County
*Bank ABA No.*Bank Account No
*Bank Account Name Bank Contact
Credit Information
Correspondent Bank (if any) Name/City
Bank ABA No:Account NameAccount No.
CONFIRM THE INSTRUCTIONS FOR WIRE AND ACH TRANSFERS WITH YOUR LOCAL BANK. ACH INSTRUCTIONS MAY VARY FROM YOUR BANK'S WIRING INSTRUCTIONS IF
THE LOCAL BANK IS NOT ON-LINE WITH THE FEDERAL RESERVE. IF ACH INSTRUCTIONS DIFFER FROM WIRING INSTRUCTIONS, PLEASE COMPLETE AN ADDITIONAL BANK
INFORMATION SHEET.
**If ACH availability is selected, I hereby authorize State Street Bank to directly deposit and withdraw funds by means of ACH electronic transfer to and from the financial institution
and the account designated above ("Designated Account"). I agree that this authorization may be withdrawn with at least 45-days advance written notice to TexPool Participant
Services. I understand that the Trust Company reserves the right to discontinue ACH electronic transfer without advance notice. I also authorize State Street Bank to deduct from the
Designated Account or from subsequent deposits made to the Designated Account all amounts deposited in error. In the event the Designated Account is closed or contains an
insufficient balance to allow deduction for amounts deposited in error, I agree that State Street Bank may withhold any payments owing to me by the State of Texas until such
amounts deposited in error are repaid. Likewise, I authorize State Street Bank to credit all amounts withdrawn in error to Designated Account.
*** If you have multiple wiring instructions attached to the same account you must select the applicable instructions for that transaction. Indicate if instructions referenced represent
primary instructions by checking the appropriate box. Trades placed via EDGEnet or the VRU will always be sent to the primary instructions. If you need funds wired to another set
of instructions please call a Participant Service Representative.
NOTE: This authorization must be executed by two current Authorized Representatives of the Participant as set forth in the duly enacted Resolution of the
Participant, which is on file with TexPool.
As a current Authorized Representative, I certify that the above information is both true and correct.
Authorized Representative Signature*Printed NameTitleDate
Authorized Representative Signature*Printed NameTitleDate
TexPool Prime 590
TexPool 449
June 9, 2008
Town of Westlake
3 Village Circle, Suite 202
3 Village Circle, Suite 202
Westlake TX 76262 Tarrant
78200 Debbie Piper
2200800012 817-490-5712 817-430-1812
Arts & Sciences Center CM Retainage dpiper@westlake-tx.org
First Financial Bank
95 Trophy Club Drive
Trophy Club 76262 Denton
General Fund Patti M. Daniel
Thomas E. Brymer Town Manager 6-9-08
Debbie J. Piper Finance Director 6-9-08