Fillable Authorized Account Signers Signature Form (California State University, Fresno)

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Authorized Account Signers Signature Form (California State University, Fresno)

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The Authorized Account Signers Signature Form (California State University, Fresno) form is 1 page long and contains:

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  • 12 check-boxes
  • 35 other fields

Country of origin: US
File type: PDF

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Chapter and Club
Authorized Account Holder/Signer Signature Form
Fresno State Alumni Association | www.fresnostatealumni.com | Phone: 559.278.ALUM | Fax: 559.278.6790
Chapter/Club Name:
____________________________________________________________
Date Prepared:
____________________________
Effective Date:
New Authorized Signers are effective as of the new fiscal year, July 1.
Chapter President:
____________________________________________________________
Instructions:
1. A minimum of three (3) account holder/signers is required.
2. All individuals possessing account holder/signer privileges must complete the fields below.
3. An account holder/signer does not have to be an officer of the Chapter or Club.
4. The Authorized Signature Form must be renewed/submitted on an annual basis.
AUTHORIZED SIGNER #1
Print name:
_________________________________
Signature:
___________________________________
Date:
If individual is not a current officer, the information below must be completed:
Address:
________________________________
City:
_______________
State:
_____
Zip:
______
Phone 1:
_______________________ Cell Home Work
Email:
_________________________________________________
AUTHORIZED SIGNER #2
Print name:
_________________________________
Signature:
___________________________________
Date:
If individual is not a current officer, the information below must be completed:
Address:
________________________________
City:
_______________
State:
_____
Zip:
______
Phone 1:
_______________________ Cell Home Work
Email:
_________________________________________________
AUTHORIZED SIGNER #3
Print name:
_________________________________
Signature:
___________________________________
Date:
If individual is not a current officer, the information below must be completed:
Address:
________________________________
City:
_______________
State:
_____
Zip:
______
Phone 1:
_______________________ Cell Home Work
Email:
_________________________________________________
AUTHORIZED SIGNER #4
Print name:
_________________________________
Signature:
___________________________________
Date:
If individual is not a current officer, the information below must be completed:
Address:
________________________________
City:
_______________
State:
_____
Zip:
______
Phone 1:
_______________________ Cell Home Work
Email:
_________________________________________________
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Authorized Account Signers Signature Form (California State University, Fresno)

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Completed 19 July 2020

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