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<br /> • STAT�TREASURER + �' Mail t0:STATE TREASURER JUDY BAAR TOPINKA
<br /> JUDY BAAR TOPINKA ATfENTION:THOMAS C.MCNICHOLS,DIREG70R
<br /> THE IWNaS FUNDS
<br /> � Money Market Fund ��������
<br /> •.;;.: :::
<br /> 3OO WEST JEFfER50N ST.
<br /> �> ? ` '' � '` SPRINGFIEID,IWNOIS 62702
<br /> � � FORMALLY KNOWN A$IWNOIS PU&JC TREASURERS'INVESTMEM POOL.. ..
<br /> APPLICATION AND AGREEMENT TO PARTICIPATE IN THE ILLINOIS FUNDS
<br /> " (First National Bank of C"eiral Illinois - Custodian)
<br /> �New Account Application ❑Change of Information. ,, ., , , , , � Date 6-10-9 7
<br /> Transaccion Account# 7139107192 Investment Account# 7139223452
<br /> The Public Agency listed below,("Participant"),seeks to participace in the Money Markec Fund within The Illinois Funds,escablished pursuanc
<br /> = co Seccion 17 of�he S�ate Treasurer Ace{15 ILCS 505/17),which auchorizes the Treasurer co establish a Public Treasurers'Investmenc Pool.
<br /> � �1. ('i v of D�catur • 37-6001308
<br /> • (1Vame of�ublic Agency) (FEIN Number/TIN Number) ,
<br /> ,', (Subcicle of Accounc,if any)
<br /> #1 Gary K. Anderson Plaza Decatur Macon 62523
<br /> (Screet Address) (Cicy) (Councy) (Zip Code)
<br />,,......--,-_,.� . _. _ .�. -.� �::a�-�..._�x,..�;-.�..... _ - ,-- -- •.-._____s> _.. ,� -z�
<br /> . � ._.._ _. . .
<br /> (Concacc Person) ( elephone Number) �(FAX umber) .,._ y�
<br /> 2.Any sale or discribution from che Funds by wire transfer shall be paid by che Funds to:
<br /> S@2 atta�ht�d listing For credic to the account#
<br /> (Name of Deposicory Bank)
<br /> ABA# Atcention:
<br /> 3.The par�icipant hereby requescs Direct Deposit of che following Scace of Illinois discributive funds:
<br /> (FOR OFFICE USE ONLY) '
<br /> Depc.of Revenue: �Auto Rencal Tax Illinois Scudent Assiscance Commission: (Foa o�icE UsE o��r)
<br /> � Income Tax ❑
<br /> �Sales Tax Secre�ary of State: ❑School Library
<br /> Q Personal Propercy Tax �Public Library
<br /> ,::. ;:::::.::;:::.:::..:.. .:. ,- .;
<br /> , ;. ,..�.�
<br /> :::: -.
<br /> �Gaming Funds -_�;;�epc.of Public Aid:
<br /> ❑RTA ❑Public Assistance
<br /> Depc,of Transporcacion: . Imprest Funds:
<br /> <.::::::,:;:;::..:.:..:..:.
<br /> �Mo[or Fuel Tax ;.;::::::::.,.,:;:::;:....::... <.`. � ,
<br /> ::.:.. . .,::::::;::,.:.; ;. ::..:.
<br /> ,. .
<br /> ; .
<br /> Depc.on Aging: State Universities: ❑
<br /> ❑AAA Paymenc >:....:_:.:: _:::::..;. ❑ _ ..
<br /> < :::;.:<;,:::::>.::>:: : ::... _:.:... .
<br /> Stace Board of Educacion: Dept,of Veterans'tlffairs
<br /> ❑All School Payment ' ' ` ❑
<br /> ; ..
<br /> Illinois Communicy College Board: Ocher: ❑
<br /> .. � y[]Funds , ❑
<br /> - ..._ _4-_�,...._�...__._ __.� �,._:.�-..,,..,...r.,._.__: .:. ..... _,_,�.:.�_... ....,..c. -_�-._. .. _ - _ - < _ .,-r .Y ..- -- -
<br /> -.::.--_.�,.._,-->:�- _.__ ,. _ _. _ .� _ -- -- ._:..:...
<br /> 4. Income will be: ❑Automatically Credited or ❑Discributed by Check.
<br /> 5. Requesc standard business checks: ❑
<br /> 6.The following person(s)is(are)auchorized to execute wire ctansfers and/or sign checks,as indicated:(if more than 4, rubmit.reparate theet)
<br /> Authorized Signature Printed Name Wire Transfer Sign Checks
<br /> 2.•� f�• �'� Beth B. Couter X X
<br /> � ��., r,�n.�+-� _ Patricia L. Hansen X X
<br /> ►�'• 'i �-u-.--.� Jenette M. Heidemann X X
<br /> c. ��,,,�..
<br /> 7. Comments:
<br /> _ 8.The participanc accepts the terms and condicions of che administration of The Illinois Funds as ouclined by the Scace Treasurer wich che
<br /> � understanding chat there will be no changes to chis agreemenr and che information contained herein wi�hout prior writcen nocice.
<br /> : 9.The undersigned cercifies tha /she ha t o ized by Parcicipant's governing body to execute this Application and Agreemenc on
<br /> behalf of che Participanc. /,,,�
<br /> : Signacure: �✓/� � Posirion/Ticle: City Manager
<br /> F THE ILLINOIS FU DS-WHITE COPY • PARTTCIPANT-YF.i,T,(�W CnPY
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