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TRUIST SIGNATURE CARD (FLORIDA) <br />NAME AND ADDRESS OF DEPOSITOR <br />CITY OF ZEPHYRHILLS <br />5335 8TH STREET <br />ZEPHYRHILLS, FL 33542 <br />ACCOUNT NUMBER <br />0569000000124 <br />Opened/Updated By <br />OWNERSHIP DESIGNATION <br />COUNTY <br />ACCOUNT OPENING DATE REVISED CARD DATE <br />/11/2023 <br />App.ve. s. E.TORRES/D43740 ^^^ <br />Type of ID <br />Second Type of ID <br />Issued By <br />Issued By ID Number <br />IDENTIFICATION <br />Expiration Date Date of Birth <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 Issued By _ ID Number <br />Second Type of ID Issued By ID Number <br />Employer <br />Address as listed on ID <br />Exoiration 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 />[I Individual I Sole Proprietor / single-member LLC \ | C Corporation || S Corporation || Partnership |] Trust/Estate \ | Limited Liability Company <br />Enter (he (ax classification <C = C corporation, S = S corporation, P = Partnership) <br />Note: Check the apprprlate box In line above for the tax classltlcaflon of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is <br />disregarded from the owner unless the owner of the LLC Is another LLC that Is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a smgle-member LLC <br />ffiaf is disregarded from (fie owner should check the appropriate box for the tax classMcation of Its owner. <br />g Other (See Instructions.) COU NTY <br />Exemptions: See Instructions Exempt Payee code (If any) \ \ Exemption from FA TCA 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 (IPS) that it is subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS 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 FATCA reporting is correct. <br />Certification Instructions. You must cross out item 2 above if the Depositor has been notified by the IPS 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. Instructions to the Form W-9. includina definitions. are available unon reauest. <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 ACCOUNT <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 />TIN of Signer <br />CITYOFZEPHYRHILLS <br />Printed Name of Depositor <br />Melonie Bahr Monson <br />Printed Name of Signer <br />^^ki <A^ <)^tSA-~ <br />^n\e, ^ahrl^n^^. ^^ <br />PNTmeed/Titie: Melonie Bahr Monson, Mayor <br />..^A^>^ <br />5/8/2023 <br />DATE <br />5/8/2023 <br />DATE <br />8005XX_BB (2110)