Sample Bank Account Authorization Form


MASSB Foundation
103 Market Street
Annapolis, MD 21401

trustee@massbfoundation.org  /  (443) 756-1116

[Date]

[Bank Name]

[Bank Address]

[Bank's City, State, and Zip]


       Subject : Request to Open a Checking Account


TO WHOM CONCERNED: 


Being duly authorized to act on behalf of the trustees of the MASSB Foundation, the undersigned trustee of the Foundation hereby requests  that a checking account be opened as a component fund within the MASSB Foundation:


Local Account Name: _____________________


Contact Person for Correspondence: __________________________________


Mailing Address: _______________________________________________________


Telephone: (____) ____-_______.   Email: ____________________@___________________.____


Please ensure that all associated account documentation is imprinted with the Local Account indicated above. Further, the account should reference MASSB’s Federal Employer Identification Number (EIN): 26-1192752.


Each check must be signed by one [OR: a combination of any two] of the following three people whose signatures appear below:


  • Printed Name:  _________________________________ . Signature: _________________________


  • Printed Name:  _________________________________ . Signature: _________________________


  • Printed Name:  _________________________________ . Signature: _________________________



Signed on behalf of the MASSB Foundation by --


Trustee's Signature: _______________________________________________


Trustee's Printed Name: ____________________________________________

  Maryland Family Assistance Funds