EFTA01580456.pdf

Funds Transfer Request (Please Type Instruri. ions) J.P.Morgan or-4a-t Effective Date: Th 12/08/12 Please enter current or haw° dete only Select Appropiate Payment Type and Fields will be Displayed O JPMC Transfer O ACH 0 Chet< C) Domestic Wire C) International Wiro Principal: 15228.87 Income: Originator Itilartitution Ja.ritt Debit Account if: Debk Account Title: Jeffrey E. Epstein =ar r . Address 1: Receiving Bank ABA: 021000021 Receiving Bank Name: JPMorgan Chase Address 2: Beneficiary Account ff: Beneliciary Name: City: State: Zip Code: 71rPUgli'lnlerrned a'y Part? (II Required) #1. Account Type: 0 DDA (US) 0 Swift 0 Other Intermidiary Bank Account/Code: Intermediary Bank Name: Payment Details (Reference/ Advice Description/Addenda) r Reimbursement for I 'iguana had 11/27/12 Authonz • , By Date ID 036212067821783 DATE: 12/06/2012 21 1REpapkt 2 of 2 DID: 11l49 JJ1NDEX1 INDEX2 PAGE 2 OF 2 Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00059792 EFTA01580456