Accountant Authorization

Accountant Authorization
Division of Glacier Bank
MOUNTAIN WEST BANK
PO BOX 1059
COEUR D’ ALENE, ID 83816-1059
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I hereby authorize ______________________________________________________
(Name of Accounting Firm)
to release a complete copy of my Individual Federal Tax Return, Partnership Return, Corporate Return, or other
business returns, that are applicable to Mountain West Bank. In addition, this authorization is valid for the term
of my commercial loans with Mountain West Bank unless I notify the Bank and the above mentioned accounting firm in writing of the termination of this agreement.
__________________________________________
Printed Name
____________________
Date
_______________________________________________________
Signature
Address of Accounting
Firm:
_____________________________________
_____________________________________
Phone Number of Accounting Firm: _____________________________________
FAX Number of Accounting Firm:
_____________________________________
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