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• <br />Repetitive Wire Authorization <br />❑ Domestic <br />❑ New Repetitive <br />*FIRSTAR <br />Repetitive Code <br />❑ International <br />❑ Change Repetitive <br />❑ Delete Repetitive <br />Originator Information* <br />ORG: <br />ORG /ACCT: <br />ORG Address: City: State: <br />OGB: OGB/ACCT**: <br />OBI: <br />Beneficiary Bank Information* <br />BBK Name: City: State: <br />• <br />ABA: Country: Foreign Currency: <br />Y : <br />BBI * *: <br />Beneficiary Information* <br />BNF: <br />BNF /ACCT: <br />BNF Address: City: State: <br />RFB: <br />Authorization Information* <br />Customer /Company Name: <br />Authorized Signer: <br />Print Name: <br />(Signature) <br />Phone:( ) <br />Date: <br />*See abbreviated definitions on back. <br />* *This information may not be required to complete a repetitive wire request, see definitions. <br />ADOPTED BY THE LINO LAKES CITY COUNCIL THIS 24TH DAY OF <br />MARCH 2000. <br />John J. Bergeson, Mayor <br />ATTEST: <br />Ry -Chel Gaustad, CMC City Clerk <br />