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<br /> <br /> <br />EXHIBIT C <br /> <br />This form must be submitted with copies of bank statements or certified financial reports from the Grantee <br />that verify the account number. date and amount of deposit, interest rates and total interest earned as of the <br />date o/this report. <br /> <br />Grantee. <br /> <br />Bond Series & other .. . ... . .. <br /> <br /> <br /> <br /> <br /> <br />AUTHORIZED SIGNATURE & TITLE <br /> <br />DATE <br /> <br />Building Better Communities <br /> <br />Exhibits - Administrative Rules <br />