EFTA01580275.pdf

Funds Transfer Request (Pk. Two InthucteOnS) J.P.Morgan Effective Date: 104/24/13 Ptit&Tft Grow plan a Munn date only Select Aporopiate Payment Type and Fields mil be Displayed 0 JPMC Transfer 0 ACM 0 Cheek CID Domestic Wiro 0 International Wire Principal: $15,294 73 Income: afrOrifkap* Debit Account 0: Debit Account Title: g'acjg Address 1: Receiving Bank ABA: 401 East Jackson Strant Receiving Bank Name: Sunirust Bank Address 2: Beneficiary Account a• Beneficiary Name: Kellerhals Ferguson Fietcher Krobli City: fr— arni Slate: iFr ---- 1Zip Code: 33602 Account Type: ODA (US) 0 Swift Intermidiary Bank AccOuntiCode: Intermediary Bank Name: Pt" Payment Details (Deference/ Advice Description/Addenda) / 1/ 04124/13 Authorized By Date ID: 038304245402945DATE 041241201318:51:00Page 7 of 8 DID: 731 17CSID: INDEX1: INDEX2: Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00059578 EFTA01580275