EFTA Document EFTA01481235

APPLICATION COPY CHEMICAL PERSONAL SIGNATURE CARD Chemical Bank BRANCH ACCOUNT TITLE (A JOINT ACCOUNT IS PAYABLE TO EITHER OWNER, OR THE SURVIVOR). 2 digits FOR BANK USE ONLY AND a t v•-r- itVhq-1 ACCOUNT NU ER - or 12 4 BAC/PROF1T C 0712'1S 7- TAXPAYER IDENTIFICATION NU PRIMARY APPUCANT'S TAXPAYER ID# 6 7 UGMA MINOR'S TAXPAYER ID 0 1 CHECK ACCOUNT ARRANGEMENT: CHECK ONE: BER(S) SECONDARY APPLICANT'S TAXPAYER ID 0 10 &<idividual 0 Joint 0 Estate/Trust 0 Other El None El