PDF-Permanent Account Number (PAN)

Please read Instructions. This account number w ill be accessed while paying your bills using the Bil lPay facility This will also be set up as the default account for the MobileBanking Service using SMS FULL NAME CUSTOMER ID NO DEBITATM CARD NO PRIMARY ACCOUNT NO Yes I wish 1 AXLES COMBO NO 2 AXLES COMBO NO 3 AXLES COMBO NO 4 AXLES FEE BASIS M MILEAGE F FLAT C CHIP TRUCK D DUMP TRUCK F FLATBED G GARBAGE K SELFLOADIING LOGGER L SHORT LOGGER OR MULE TRAIN 1L LONG LOGGER M MIXER R VEHICLE CARRIER S LIVESTOCK T 1st Holders Permanent Address Please tick in case permanent address is the same as mailing address State Pin Code Country Flat No Bldg Name Road NoName Landmark City 1 1st Holders Mailing Address State Mobile Phone Res Pin Code Country Flat No Bld When a person with a permanent residence outside the U.S. but who wishes to be in the U.S. on a temporary basis (i.e. Tourism, medical treatment, business, temporary work, or study). Form-94 with one of the endorsements given in the eligible document section. Nonimmigrant visas include the F-1, F-2, or M-1 Student Visa, B-1 or B-2 Visitor Visa J-1 or J-2 Exchange Visitors Visa, H series or L series Visa (which allow temporary employment in the U.S.), or a G series Visa (pertaining to international organizations). Someone who has only a “Notice of Approval to Apply for Permanent Residence (I-171or I-464)” cannot receive financial aid funds.. Name:____________________________________________________ laim Number:_____________________________________________ lease indicate type of account: Savings Telephone NumberName and Address of Bank o A citizen or lawful permanent resident of the United States may �le Form I-130, Petition for Alien Relative, with U.S. Instructions for Form I-130, Petition for Alien Relative, and Form I- Moving your number to GoMo Option one If you would like to m ove your number when you are sign ing up to GoMo 1. Select 'Keep My Number' as you are purchasing your GoMo SIM 2. F ollow the steps bel Full Name on Your Account: Full Name on Your Account: SECO Account Number: SECO Account Number: Your Telephone Number Your Telephone Number (\b \t\n\t \f Members Signature Date Witnesss Signature Date If your signature is not witnessed by a credit union employee this form needs to be notarized Subscribed Page 1 of 6Irrevocable Contribution Form and Letter of InstructionUse this form to make irrevocable contributions to a Fidelit Charitable Giving Account or a Giving Account that is enrolled in the Cha All EFT requests are subject to a 15-day pre-certi31cation period in which all accounts are veri31ed by the qualifying 31nancial institution before any Medicare direct deposits are madePART I REASON F TD F 90-221 Department of the Treasury Do not use previous editions of this form REPORT OF FOREIGN BANK AND FINANCIAL ACCOUNTSDo NOT file with your Federal Tax Return OMB No 1545-2038 1 This Report MACH BCE-MACH LLC - DIRECT DEPOSIT ENROLLMENT FORM The undersigned hereby authorizes BCE-Mach LLC and its subsidiaries to make electronic funds payments via ACH to the named companys bank account This Surjit S BhallaThe Measurementof Permanent Incomeand Its Applicationto Savings BehaviorReprinted with permission from Journal of Political Economy vol 88 no 4August 1980 pp 722-44 Copyrighted by the U