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STATE OF INDIANA STATE BOARD OF ACCOUNTS 302 W. WASHINGTON ST., E418 INDIANAPOLIS, IN 46204-2765 TELEPHONE: (317) 232-2513 FEDERAL IDENTIFICATION NUMBER: 35-6006977 UNIT NAME: BRISTOL PUBLIC LIBRARY

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1. Start by entering the date in the designated space on the form. Make sure to use the correct format (e.g. MM/DD/YYYY).
2. Next, provide your full name in the designated field. Use your legal name as it appears on official documents.
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4. If applicable, indicate any apartment or unit number associated with your address.
5. Write down the name of your city or town in the corresponding field. Ensure that you spell the name correctly and use proper capitalization.
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7. Provide the ZIP code for your address. It is crucial to input the correct ZIP code to ensure accurate delivery of any correspondences.
8. Indicate your phone number in the designated space. Make sure to use a working number that you can be reached at if needed.
9. If requested, provide your email address. Double-check for any typographical errors to avoid issues with communication.
10. Sign and date the form at the bottom, confirming your understanding and agreement to the provided information.

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