How do I fill out the 'Relevé Comité et Associations' form?

1. Date
2. Account number
3. Cross out what does not apply
4. Names of committee members
5. Text field reserved for Spuerkeess
6. Signature
7. Member(s) with individual signing authority
8. Member(s) with joint signing authority
9. President’s signature
10. Secretary’s signature

Please fill in the fields as shown in the illustration.