ASSIGNMENT OF SAVING ACCOUNT/CERTIFICATE OF DEPOSIT
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ASSIGNMENT OF SAVING ACCOUNT/CERTIFICATE OF DEPOSIT This assignment is for the purpose of fulfilling the requirement of bonding collateral for Permit ____________. The undersigned does hereby assign, transfer, and set over unto the State of Washington all right and title to $_____________ on _________(Account No.) in the _________ Branch, ________________________ Bank, in the name of _________________________________ with full power and authority to demand, collect, and receive said deposit and to give receipt and acquaintance therefore for the uses and purposes prescribed above. It is understood and agreed that ________________ Branch, ______________________________ Bank holds the Certificate covering said account in its possession and agrees to hold $__________ until a release of this assignment form the State of Washington is received. The interest shall be payable to ______________________________. Signed and dated at ___________________, 200___. _________________, Washington this _______ day of
___________________________ Signature ____________________________ Address
ACCEPTANCE The undersigned hereby accepts the foregoing Assignment of Savings Account/Certificate of Deposit, Account or Certificate Number _______________, in the amount of $____________ this _______ day of ________________, 2000__.
___________________________ Bank ___________________________ Signature ____________________________ Title
file://\\Chinook\DevWebs\Test\regions\Northwest\Snohomish\DeveloperServices\Assign... 12/30/2003