Fillable Fasig Fiscal Agent Signature Sheet (Western Illinois University)

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Fasig Fiscal Agent Signature Sheet (Western Illinois University)

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The Fasig Fiscal Agent Signature Sheet (Western Illinois University) form is 1 page long and contains:

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  • 3 check-boxes
  • 28 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Western Illinois University

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Fiscal Agent Signature Sheet Date: ______________
ACCOUNT #: ___ New Account Request
ACCOUNT NAME: ___ Account Change
___ Close Account
FISCAL AGENT NAME: ______________________________________________ WIU ID #:________________________
(Please print or type)
SIGNATURES
FISCAL AGENT: ____________________________________________________________________________________
ALTERNATE ONE: __________________________________________________________________________________
(Print or type name) WIU ID# (Signature)
ALTERNATE TWO: __________________________________________________________________________________
(Print or type name) WIU ID# (Signature)
ALTERNATE THREE:_________________________________________________________________________________
(Print or type name) WIU ID# (Signature)
ALTERNATE FOUR:__________________________________________________________________________________
(Print or type name) WIU ID# (Signature)
Previous Fiscal Agent's signature:_____________________________________________________________________
PURPOSE/FUNCTION OF THE ACCOUNT:
MAJOR SOURCE(S) OF FUNDS:
EXPENDITURES:
COMMENTS:
MONTHLY REPORTS: (besides the fiscal agent, list name and email of others who should receive the monthly reports)
Please print or type name, then sign.
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Fasig Fiscal Agent Signature Sheet (Western Illinois University)

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Completed 9 February 2021

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