State of Connecticut Accounting Manual RECEIPTS BANK ACCOUNT ESTABLISHMENT REQUEST EXHIBIT 2-1

Exhibit 2-1a

State of Connecticut Treasurer's Office Seal

State of Connecticut Office of the Treasurer
Denise L. Nappier
Treasurer		 Howard G. Rifkin
Deputy Treasurer

To: Cash Management - Bank and Check Administration

Agency Information Contact Person:
Agency Number
Name
Name
Title
Address
Phone #
City
Zip
Banking Information
Name 
Address
City
Zip
Type of Account:
(Please select one)
______ Savings Account Name
______ Checking Account Number
(to be assigned by bank)
______ CD
______Other, Please Specify
Authorized agency Signatures for Account (Signature, typed name and typed telephone number). MINIMUM OF TWO SIGNATURES NEEDED PER ACCOUNT

TR01

55 Elm Street, Hartford Connecticut 06106-1773, Telephone: (860) 702-3000

An Equal Opportunity Employer
ACCOUNTING MANUAL 2-22 FEBRUARY 2001

EXHIBIT 2-1a

BANK ACCOUNT IDENTIFICATION
Page 2

 

Purpose of the account:

 

 

 

 

Bank services being provided for this account:

 

 

 

Please leave this area blank for Treasury action.

Date received _______________________

Matched CO929

Master file entry

 

PLEASE PROVIDE ALL REQUIRED INFORMATION

 

 

TR01

ACCOUNTING MANUAL 2-23 FEBRUARY 2001

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