EFTA01268301.pdf

(Page 1 of 3) May. 8. 1014 3:3/PM Ashturd at 41lag Lake 96/l 'ow IkvII 11 rti6E9c6 114 n11. paAif"Il l 10 Ameritrade Entity Authorized Agent Form rPO 8ce 2209 *Omaha, NE 6833-2209 Fax; 866468.5268 questions? Calla Clont SeeviceS eepresenta dye at 800489-3900, Duo ate bs e Wietina '<toss/ ONew WAWA I. ENTITY INFORMATION I0 Mater a- 7 S0Uthifin Trust Sit Et rwletimi atenta Mast PM PO WO! Ma drop)* 100 Rea SOO Quarter 83 b4. ilt/TO6 stew 1OP Mt meihnit meow I ()yam 0 0 8 0 2 iedifferail from alien) Cky: DP Cods: "ral 4 Q_7 7 1_ ,2„, 5 2 1_ Sunder here Net esse Otquirstibr *Capp d.niyo M-2.2t-4).ralt flu, &sew stetrowes Md had* tonSmaSs9/ Mt/ 5. &ay )fore* &iffy- Caafty of Foserstssil 814:40nMior alForreglOriPpartutiort 001199049/9090 fav WE) United Slates VInab Islands Ties cie butts:au Consulting Is aril • Poiedirmolassol Vatitin Eke NNW bt a hat acceurd. . Na•• WO* Wt. at On ils4 Oft a bemiker Ifs Carole decor& pain Irdboti nib 8-0:001100 by the ittre.0 non eft/ himtidy waded comet% Om way the Mod snot 7. AUTHORiZED AOSIII:PARTNEMTRUTIEEIO FFICER INFORtitAlION PfSfa FaL Law! Mere! LAI pa. ON °Rev. Jeerey Epstein, Pf9.910(911 00 of kW A,,A.Du.yyty) 0 _2 0 _1 9 5 3 ILG.Scs;e1emit/ WOW Alain. fly PO lisarme owl la a Jima, island Obt St. Thomas I mws. us 0 0 8 0 2 Few fetefeleinv rimsmoloved Deana Owe......moo. Etatooece 0 Some of Wets (Intindorms49900940: elreplayed Patentee Eopuruttom Southern Tnat Company, Inc Occomesertypsoleoustee eetesesianistMenu Financier/Gen:Meng 6100 Red Hook ()stetter 83 Z:71'00189 mow, addr USVI 0 0 8 0 2 new. firma amen ISMXOPY rug PIXOCIL IIIIIIIIHIIIIIII III hp1d3 Mt 1111F MN 91: t1I10Z/6090 910 Z //09d cesw1OENTIAL SDNY_GM_00012178 sadOSt WHO 124 e/Opy WOK) /ittoiS EFTA_00122829 EFTA01268301 Inge 2 of 31 Mai. b. (V 4 i:3/11•1 Ashleď4 sl Laks 06/I .1;16/2'1'6 •Ni3n!I P"!»4 eftt LIMA O4441. ow Ø. • ' US. $or.al ~Milt« • • Dim-co•Yrm ESSA'? (no POL,•« Me drop) 1 • •• Sota Sn elbroťn• (ftcrir•I••••••WcY4P. ElHoeno•••Lv ❑Coadeti CiCalďnyloye• 0044~44 Of Illairaz • • • Enploger 8YOe1 Addnarts: 1f nou. Mins sutini a phxce..);y ,cer pm:Li port. Rett Fdl (»gid ~e Ebk CM.. p 4*. 00t. DR« ....... . 041* ent. us. Sope salg - • . vAll.00-Prn) rssi•o• ••••! ,m~! ••=.1— ••••• tam ~ren . • . (CO PO bua-~dtp) . • .. • . Piss& aps«, o ›•• . • .•• • SOn ot Occm• (dnis 1 ah~sq: rilln~ pRnMeA GHonwcalt• nStuck..1 nS44Employed ESI, Nano‚ Ounnuonnict oilbiask • 7IP f.e", Dart seng mb,' e prepopg or pur DanPal ant. med ~do mota u n••••••7 3. AFFILIATI0NS Elehock bere i orry PrrinufkinotreaĎOM. Trut" offic.r. any Neinip ri the:1~as fan.% or *ny t•AVROVII noc o/ Inni temt pnVal • %ute (Sn) Sp041.Y11,4 ria Cl 0,41~5 Prnt. *arr* Cn• SP,. «Smi Mit plakeshrp (0 UP ~ad kei tad country ri titte nO‘ect Seil arri Nbiňt•Molhoneorl Apent TnaltO Ot Diket • • cins rpa, fri* 01 M •afflonant •••44.4.. oompecny tiar syn« munk ens•••1194 r felcy-44•~CasZt Ot a CSerlt kor.tod ccrnpany Soeca, m. 40.2104. CIM vd stattPrOrra EJC.Nces Mnd lyg P winamianle segn. mina ed Mei tomegd 0( einpkye4 by la ~ml eecufdae bmagaYle CIM 4~4 i cartiberta Wår abi wn llo morěavin spåttly ot *.n. ~ist Menignr a Li.» ~wiren ilrfnelrbør 0( Aset •• - 4. INVCSTMENTS MUTTE!) TTID tendeisigned COrVy timt mo engry °mus!, ptrchain segl ulot ei tpc3 I nCriCated bůICA• snaktis in Om ~tg typ....4 ~mb an wci ac ab ranamon . fatiah 094tOc.:2W44S com ed Ca. Wc411C1.11•SCISÍtůilt . - IZI64.(144,iiiiiii . . .. . • . Mmurg;n - LiPurchato opticro •: iatOtrOtiraiittlaitte ."` - . . ...... ••• • • . • • , ..„ ..... '• ‘„ „„ „.... •• .• • •••• • • • , . . • • -. Pipla. • .• . -. . „ .. . TrAllIngit ... - , • •••••• - : • .... • 9,p•s 41) . .... . iic....,-- : ..501.j9 EM : .- 0001ill 63179) -Szed. wilitut 411•0 :0101i . • : EFTA_00122830 EFTA01268302 (Page 3 of 3) May. L014 j: Ashford al Spring Lake 86U 'oti 1;10 2"..r6 Phi. ;8 S ACCOUNT ADREEDIE141 In tlas agroomoit 'Account Oemerry endive( reelb theintletrbr Mob Pie spoor b establishedWks the Woof parsion(s) atithcened to represent and action wag d lbo enkit Under penalise of wee% I tartly () het Pte Social Staley Number gnomic on INS forma my coact lexpeyw ididerloatien nesting. (z) that i elii our euhlect to backvp witnnoieng, and (3) Bret / ant a U.S. Pinar. (inratICVMY b Milani alien); provided, Ittrevhes If I are a neneoldent alien as &closed In INT eppieeton) do no: cergfy that I am a US Potion and I tmderstond /hill must subrell 0 FOOT bv-SBEN. p I haw been octlIWO by ihe IRS the/ler sutioxl In backup wtthholoting am coattail of *Mord or eland undetri7PORMO. Mitt CMS Out (2) to (Ns avelealkin. I eicenobledge Dill have rocektfl and road tglard Agreement,' replabta al wrowtdamentgde.COM Of by calla* 800409-3900. Mal air govern my accounl. I Some to ba bound Be by the Tient Agreement' which may be smoneroo bow limo to ern* and vrielth is Ineorwated Liy tide manna I rowsn ana agree to int/mity and hold humicie TO Amentrade. Inc.,do divisions and dans owned no nmentnrael from any and alt gabby and fatten Ice damages resoling from any action taken pursuant to fib agreement. By my sigriature babe( attest that on of fugal age loctwilmet and that the Mformabon contained in race epplicafon s rue and aorrect The ClIwtt Agroornent• appacahle le this brourega account agreement contain* prridhaiut• sistnicalion clanM. By Opting Ws agreement The pa riles &gnaw be bound by the team of to &groove WireIon In Cannon is or the Client Agreement All booslot, oneseiato end proceeds wig halo int, Mcludbip Ike arbitration agreement be all) Arnernaklb Chonrig. Inc. unless oU,ornlse instrocbgli understand doe TD Amentrede may obtain a cturent tOnsurner a wen rout decw b mine my eicibiliby, or oomimang ediabigly for credit or for olher legitimate business purposes My decision by TO A/nadirs:fa to ciderd credit may In hated on Inlomution contained n a CAISUMOi Or Ueda Mint, as mil as the pack* of ID Arnorkrado Clearing. kw.l taiderstand Oat TD Ameritrado may relate rfonnadOn regarding Ns accotrd, "Aiding axounl delnquircy and sal cry downs, to consumer or cm& ceparna agendas Upon my rearrest. To MUMMA% cent Orem me or each CMG! Met or omit repo ,9 inserny yin which they have ',gained MICIfOr repelled my consumer a eredll report. TO Aprenfrade wets to nolgy the Celfrawnyr cif credit reporting agencies I i dispute Me cOmpletniNast a lemirecy of Me Worms/Jon funiatiod by TO AMerkrade. I/flays/vision beasts! atdhOlZe TO Amerbede to Obtain COrtettMar a Matta Monts et the name(s) se: maul below I underhand turnorpthiposn bsnicarnOnts otactssed TI) Amerind; are not insured by the Fodcnl Cappool hISUinfieb COrlsbrgliOn (FDIC), ore eel obligations of or guittlehred by any financial InSilbsion and ars sub*I to ittetstment risk and may woad the inwited Impartenll,tbmnilo,t alemet pro cm' ince for °pinto's new account; lb help Ana government bee Met tignt the funding of WfrOnsin anti money taublaring activities, federal law madras all !Inane-lei Institutions to obtain, verify and ',COOS Infie)ThatiOn that Idenbrbe each penion who opens en account. What this means for you: When you open an account, we lent oak for your name, ea dote 3, hale of Dinh and oI hot infOrrtillholl that wit slew is to Identify you. We may *la alblie a thtrd-party Mrormellon provider for ucrecallon purposes and/or ask fort copy of your driver's llama or other identifying documents. The Internet Revenue Service Soo, not WIWI. boots nentant to any pr via kin of Mt* cleconeant *Mee than Mc vet tinualvi) inpalicd to ovoid backup withholding. All Authorieed Agogis. Parleys, Trustees and WWI Mint moykly Owl( signatures seiNtreneefLed below. MI; the solinfri k Ohingh taiwilier LLC Authoncyl-AgonCe Stowe XA rno AgiwtfilignMene Peed eit irk Una -3 glit Olt .laisi . pa •••••• AognoroOd Pones Sc aha.. X RR: Deb ••• II Ms loan Is berg Used b updalg an otilhented %Tolman "slog TD Amen beta account, then theme:10g Ow needs to stga below Rwanda; Aidheilmed Ater* Coprowes: X 'MC our Limn.... _tifterata lanardatILISSLatisia ntgatu L udt wa yityit_J TO Amaicrade, Ina, member FWRAISPONFA and TO Amerind. Cleanly. no k ISMSCr pat/ owned by 1D funedesde IP Companydno. and The ToronlcaDcoBriart rifinUYSIPD. Athottladc I a badman gait C 20t2 TO Amenhede Company. Inc. NI rights reaarmal Used web pernibasn. Pege3or3 TOS11(0 /002 SDNYGM_00012180 aril el0Z/6050 9)p e 41 C FIDENTIAL ttit0-0St %Pat roe 3 mylput tidnera 31)01; EFTA_00122831 EFTA01268303