Change Of Bank Information Form - Rhode Island Department Of Health
ADVERTISEMENT
1
2AMENDMENT TO VENDOR AGREEMENT #
Name
Rhode Island Department of Health
WIC Program
CHANGE OF BANK INFORMATION FORM
What length of time has this store operated in this present location under present ownership?
Has there been a change or modification in ownership such as:
□
□
/
/
Partner(s) added
Yes
No
Date:
□
□
/
/
Deleted partner(s)
Yes
No
Date:
□
□
/
/
Corporation merger
Yes
No
Date:
□
□
/
/
Changed to sole ownership
Yes
No
Date:
□
□
/
/
Changed to partnership
Yes
No
Date:
□
□
/
/
Changed to corporation
Yes
No
Date:
□
□
“Trial” ownership
/
/
Yes
No
Date:
□
□
/
/
“Purchase or Sales” Agreement
Yes
No
Date:
□
□
/
/
Temporary ownership
Yes
No
Date:
□
□
/
/
Store sold
Yes
No
Date:
□
□
/
/
New owner
Yes
No
Date:
□
□
/
/
Store moved to new address
Yes
No
Date:
Other
□
□
/
/
Changed Bank
Yes
No
Date:
If yes to any of the above questions, give details.
Attach (tape) a permanent blank voided check from your branch’s established account for
deposit of WIC checks.
Re04/08/2010
Renewals\update vendors bank.doc
ADVERTISEMENT
0 votes
Related Articles
Related forms
Affidavit To Replace Designer Of Record Form - Rhode Island Department Of Environmental Management
Legal
Certificate Of Good Standing Application For A Liquor License Renewal Form - Rhode Island Department Of Administration
Legal
Related Categories
Parent category: Business