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Repetitive Wire Authorization <br />0 Domestic <br />0 New Repetitive <br />*FIRsTAR <br />Repetitive Code <br />0 International <br />0 Change Repetitive <br />0 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 />ABA: Country: Foreign Currency: <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 />1414"..4 <br />John . Bergeson, Mayor <br />ATTEST: <br />IIILLO i:I. <br />Ry-Chel Gaustad, CMC City Clerk <br />