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Resolution No. 815-23 Signer's on Checking Account
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Resolution No. 815-23 Signer's on Checking Account
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5/17/2023 4:52:32 PM
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Exhibit B <br />TRUIST SIGNATURE CARD (FLORIDA) <br />NAME AND ADDRESS OF DEPOSITOR <br />CITYOFZEPHYRHILLS <br />5335 8TH STREET <br />ZEPHYRHILLS, FL 33542 <br />ACCOUNT NUMBER <br />0569000000108 <br />Opened/Updated By <br />OWNERSHIP DESIGNATION <br />COUNTS <br />ACCOUNT OPENING DATE REVISED CARD DATE <br />/11/2023 <br />Approved By E.TORRES/D43740 <br />Branch Location <br />Type of I D <br />Second Type of ID <br />Issued By <br />Issued By <br />ID Number <br />ID Number <br />IDENTIFICATION <br />Expiration Date <br />Expiration Date <br />Employer <br />Address as listed on ID <br />Cell Phone Number (Home Phone Number ( <br />Work Phone Number ( <br />IDENTIFICATION <br />Type of ID <br />Second Type of I D <br />Employer <br />Address as listed on ID <br />Issued By <br />Issued By <br />ID Number <br />ID Number <br />Expiration Date Date of Birth <br />Expiration Date <br />Cell Phone Number (_) Home Phone Number ( <br />Work Phone Number ( <br />Check Appropriate Box for Depositor <br />[__](ndiwdua//SotePropnetor/smg/e-mem<)erLLC [~] C Corporation Q SCoiporatfon Q Partnership || TrusVEstate \ | Limited Liability Company <br />Enter the tax classiricatlon (C=C corporation, S = S coiporatlon, P = Partnership) \ ] <br />No(e; Check (he apprprlafe box in /ine above for (he lax classificatton of the slngle-member owner. Do not c/ieclt LLC it the LLC Is classified as a slngle-member LLC that Is <br />cfisregarded from the owner unless the owner of the LLC Is another LLC that Is not disregarded from the owner lor U.S. federal lax purposes. Otherwise, a single-member LLC <br />that Is disregarded from the owner should check the appropriate box for the lax classification of tts owner. <br />Exemptions: See Instructions Exempt Payee code (if any) \ | Exemption from FATCA reporting code (if any) \ | N/A (applies to accounts maintained outside the U.S.) <br />Certification - Under penalities of perjury, I, as authorized agent of the Depositor certify that: <br />1. The Depositor's correct taxpayer Identification number is printed below (or the Depositor is waiting for a number to be issued), and <br />2. The Depositor Is not subject to backup withholding because: (a) the Depositor is exempt from backup withholding, or (b) the Depositor has not been notified by <br />the Internal Revenue Service (IRS) that it is subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IPS has notified the <br />Depositor that it is no longer subject to backup withholding, and <br />3. The Depositor is a U.S. citizen or other U.S. person (defined in the Instructions): and <br />4. The FA TCA codes(s) entered on this form (if any) indicating that the Depositor is exempt from FA TCA reporting Is correct. <br />Certification Instructions. You must cross out item 2 above if the Depositor has been notified by the IRS that the Depositor is currently subject to back withholding <br />because the Depositor has failed to report all interest and dividends on the Depositor's tax return. <br />Form W-9 Instructions. Instmctions to the Form W-9, induding definitions, are available upon request. <br />Complete as applicable - only one beneficiary permitted if an entity. <br />Name of Beneficiary: SSN/EIN: <br />Address of Beneficiary: <br />ID: <br />Relationship: <br />Name of Beneficiary: <br />Address of Beneficiary: <br />ID: <br />SSN/EIN:Relationship: <br />Name of Beneficiary: <br />Address of Beneficiary: <br />ID: <br />SSN/EIN:Relationship: <br />BUSINESS ACC NTS <br />By my/our signature below, 1/We certify that: (1) l/We have received the "Commercial Bank Services Agreement" and the "Business Deposit Accounts Fee Schedule" <br />and on behalf of the Depositor agree to the terms of each document; and (2) 1/We give consent to verify my/our credit references. <br />Please sign beside the Printed Name(s) only. If signature line does not have a Printed Name, then a signature is not required on that line. <br />The Internal Revenue Service does not require your consent to any provision of this document other than the certifications in the <br />box above which are required to avoid backup withholding. <br />596000455 <br />TIN of Depositor <br />CITi' OF ZEPHYRHILLS <br />Printed Name of Depositor <br />^S^s- <br />elomP P^p fl^n^}^Toi/8/2023 <br />Printed <br />'Name/Title:Melonie Bahr Monson, Mayor DATE <br />TIN of Signer <br />Melonie Bahr Monson <br />Printed Name of Signer <br />5/8/2023 <br />DATE <br />8005XX_BB (2110)
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