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CITY OF MODESTO Bingo License Bank Account Waiver Name of Bank: Address: TO: City: State: Zip Code: Bingo Account Number(s): REGARDING: TO WHOM IT MAY CONCERN: We hereby give up and waive our rights from unreasonable search and seizures and authorize the bank to allow a complete inspection of our bank accounts by the Modesto Police Department. Name of the Organization: Address of the Organization: President of the Organization: President’s Signature: California ID/DL: AUTHORIZED SIGNERS ON THE ACCOUNT: Name: Title: Signature: California ID/DL: Name: Title: Signature: California ID/DL: The above signatures must be witnessed by Modesto Police Department personnel. Date: Witness: Modesto Police Department Notary