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Individuals Banking Verification Form by SBU Department

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is a not-for-profit, tax exempt corporation and contributions are tax deductible to the extent permissible by law... I certify that the individual’s bank information is accurate.

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230 Administration Building

Stony Brook, NY 11794-1188

TEL: 631.632.6536

FAX: 631.632.6918

VERIFICATION OF INDIVIDUAL’S BANK CONFIRMATION

BY SBU DEPARTMENTS

Name of Independent Contractor/Individual

Name of the Bank

Bank Account #

ABA#

IBAN # _

Swift Code # _

Please check one of following

□ Bank information was verbally confirmed in person

□ Bank information was verbally confirmed by phone and phone # _

Print Name of SBU employee who confirmed the bank information

_

Signature

_

Title

The Stony Brook Foundation Inc is a not-for-profit, tax exempt corporation and contributions are tax deductible to the extent permissible by law

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I certify that the individual’s bank information is accurate

Ngày đăng: 20/10/2022, 04:02

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