HomeMy WebLinkAboutexhibit9MIAMI-DADE COUNTY DEPARTMENT OF CULTURAL AFFAIRS
G RANTEE
BANK ACCOUNT DISCLOSURE FORM
DESIGNATED BANK IN WHICH
GRANT FUNDS WILL BE KEPT
ADDRESS
ACCOUNT NUMBER
PERSON(S) AUTHORIZED TO WITHDRAW FUNDS OR TO WRITE CHECKS:
TITLE
TITLE
TITLE
Submitted by:
(Signature)
(Printed Name)
(Date)
Sank Account Disclosure Form 1912004,J