Name:
Bank:
Branch:
Username (Example: 21_TEST):
Please check all appropriate options below:
| Delete the LNOCA account (Example: 21_TEST) | YES | NO |
| Delete from all electronic distribution lists (E-lists) | YES | NO |
| Delete report templates (templates can be copied to another staff member at the liaison's request) | YES | NO |
(Name of Liaison/Assistant Liaison) _______________________________________________________, authorize that the account for the above individual be closed as of _____________________________________________ date.