Form 9B

Authorization of Withdrawal by Teranet

Amount of funds to be withdrawn: (Specify amount.)
 
Re:
(Specify name of client.)
 
(Specify file reference number.)
 
Reason for withdrawal: (Give reason for withdrawal, e.g., payment of land transfer tax, document registration fees.)
 
Trust account to be debited:
 
Name of financial institution: (Specify name.)
 
Account number: (Specify number.)
 
Person authorizing withdrawal: (Print the person’s name.)
 
(Date)   (Signature of person authorizing withdrawal)