Signature Verification for District Escrow Account With the intent to legally bound the undersigned agrees to the following: 1. This account shall be subject to all governmental regulations, fraternal laws, and GBU’s rules and regulations as amended time to time. 2. All deposits made to this account shall be governed by the Society. Withdrawals may be made on an approved GBU withdrawal slip by no less than two of the signatures below. Federal ID Number: _
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GBU District Number, Club or Organization Name: __ Policy Number: __
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________________ President’s Name
Acknowledgement
Signature of President Vice President’s Name
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Signature of Vice President Fraternal Secretary’s Name
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Signature of Secretary Treasurer’s Name
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Signature of Treasurer Contact Person Name
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Address (Street, City, State, Zip) Phone
Signature of Contact Person
GBU FINANCIAL LIFE
memberbenefits@gbu.org 4254 Saw Mill Run Blvd Pittsburgh, PA 15227-3394 412-884-5100 800-765-4428
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