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Pass Seller Credit Application -Banking Information
<br />Bank Notification
<br />OCTA
<br />. -
<br />Contact Name:
<br />Business Name:
<br />Business Address:
<br />City: State: Zip:
<br />Accounts Payable Contact: Phone Number:
<br />.~ .
<br />Business Account Bank Name:
<br />Bank Address:
<br />Bank Phone Number:
<br />Bank Account Number:
<br />Applicant authorizes and provides permission for the release of information concerning the
<br />above referenced bank account status to Orange County Transportation Authority.
<br />Release Authorization Signature:
<br />Printed Name: Date:
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