Form Rb-32 - Expenditure Of Funds Earned Through Bingo - Illinois Department Of Revenue 1998 Page 3

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Step 3: Tell us about your bingo checking account (continued)
B - ____________
1
Check no.
Check amount
Person or organization
Purpose
Subtotal
for Page 2
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Grand total ______________
2
Write the name and address of the financial institution where your bingo checking account is kept and your account number.
_____________________________
___________________________________________________________
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Name of financial institution
Street address
City
State
ZIP
Account number
3
Write the names and addresses of all individuals who are authorized to make expenditures from your bingo checking account.
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____________________________________________________________________________
Name
Street address
City
State
ZIP
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Name
Street address
City
State
ZIP
Step 4: Sign below
Under penalties of perjury, I state that I have examined this form and, to the best of my knowledge, it is true, correct, and complete. I also
state that the information is taken from the books and records of the organization for which this form is filed.
________________________________________________________________________________________________________________
Presiding officer’s signature
Title
Date
RB-32 (R-5/98)
Page 3 of 4

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