OCALLAGHAN TRUST PAYMENT FORM.PDF

Trust/ Estate 
Page - 1 - 
 Active/51605484.1 
WENDELL COOK, TRUSTEE 
6201 N. 20TH STREET 
PHOENIX, AZ. 85016 
RE: DEBORAH S. O’CALLAGHAN SOLE AND SEPARATE PROPERTY TRUST DATED 
MARCH 26, 2016 (“TRUST”) 
We are the organization named in the Decedent’s Trust:
Yes   or  
 No 
___________________________ 
(The Organization’s name printed) 
Main contact person for organization: ____________________________________________ 
(Please Print) 
Main contact person’s Phone number: (__________)_________________________________ 
Email address: __________________________________________ 
Organization’s mailing address: __________________________________________ 
    __________________________________________ 
Organization’s Tax ID #:                    ____________________________________________ 
Until further notice, please issue all distributions payable to the referenced organization by: 
   Check   or  
  Wire to Checking or Savings account (circle which type) * or 
   ACH direct deposit to Checking or Savings account (circle which type) 
 For wire or ACH direct deposit to organization’s account, I on behalf of the    
    Organization, provide the following information: 
Name of Financial Institution: _________________________________________ 
Street Address:  
___________________________________________________ 
Phone number:  
Area Code: (__________)    ____________________________ 
Contact Person:   ___________________________________________________ 
Name on account: ___________________________________________________ 
X
Maricopa County Animal Care and Control
Valerie Beckett
602
506-2623
valerie.beckett@maricopa.gov
2500 S. 27th Avenue, Phoenix, AZ  85009
86-6000472
X

Trust/ Estate 
Page - 2 - 
 Active/51605484.1 
ABA Routing No.: ___________________ Account No.: __________________ 
MARICOPA COUNTY
BOARD OF SUPERVISORS
BY: 
ATTEST:
__________________________________ 
_________________________________
Chairman, Board of Supervisors 
Clerk of the Board
Date: ________________ 
Date:  ________________
Approved as to form:
__________________________________
Deputy County Attorney
Date:  ________________