IOLTA USE ONLY

Federal I.D. #25-1802119

Firm

Trust Account

TO:

Attorneys

(Financial Institution)

BC #

(Address)

FROM:

(Lawyers/Law Firms)

(Address)

DATE:

TELEPHONE:

Please either convert my/our escrow account number(s)_________________________titled________________________to an interest-bearing IOLTA account effective immediately or provide me/us with the necessary documents or information to open a new account in accordance with your procedures. You are hereby authorized and directed to transmit immediate notice to the Pennsylvania Lawyers Fund for Client Security* of any check drawn on the trust/escrow account(s) listed above which is presented for payment against insufficient funds. Please contact _______________________________________ from my/our office if you need additional information.

ATTN:  Lawyer or law firm administrator: 

Attach a LIST of LAWYERS who use this trust account in the regular course of their practice:
Include PA SUPREME COURT IDENTIFICATION NUMBERS before mailing it to the PA IOLTA Board.

WHITE - Financial Institution
COPY- I OLTA Board
P. O. Box 1025 • 115 State Street
Harrisburg, PA 17108-1025

* For overdraft reporting instructions contact (800) 962-4618

BY:

____________________________________
Authorized Signature should also be an authorized
check signer for the listed account(s)