EFTA01402449.pdf

EFTA01402449 Deutsche Bank Private Wealth Management Authorization for Asset Movement f"or Non-Retirement Accounts The undersigned hereby authorizes end directs Deutsche Bank Alex. Brown ("Deutsche Bank Alex Brown" or "DBAB"( to follow the below asset movoment instructions. Il.you wish to request mulirpla wires, checks, journals or free deliveries, please use the long lorm IDBAB Account Name Southern Trust Company Inc.^ Account*; 44129244 Ijournal ^_] Journal Funds in the amount of S ^ Journal Holdings: Olv/Svmbol/Secunty: Olv/Symlml.'SeciiritY: Di Journal All Holdings To DBAB Account *; ■ Name: Wire IZ) Wire federal funds in the amount of $ 200.000.00 To Bank Name First Bank, Puerto Rico City / State ABA* Further credit to Intermediary Financial Institution (Optional) Accounl #: Name Accounts' Fns© Deiivms ^ Ptease deliver the securities indicated below to: Addmonal Irtstrucbcos: DfCC^; Name of Receiving Firm: Check Q Issuea check in the emount of$ Recipient's f'teme: Recipient's f;teiing Address; Accouni Name: pavahieto Account Number: EFTA01402450 at Receiving Firm 0 ry/S y m b ol/$ ec u 11 (y, Ory/SYniboi/Securpty, Standing Authofiotion 0 Tba undersigned hereby requests that this aulhoiizaiion act as s starKtirtg authorization The understgiisd understands end agrees that Uirs auiliorizaiion wnl rernain in eP'eci until Deutsche Bank Ale>., Brown requests a new auihonzalian. Tlw undersigned aothonrbs Deutsche Bank Alex. Brown to issue the wire. check or journal on the d The undersigned further authorizes Deutsche Bank Alex. Brown to accept verbal instructions from the undersigned to wire lunds, issue checks or journal fur>ds iQ/from the above listed accounts. The undersigned will provide verbal instructions as to the dale and the amount of the wire, check or journal- If the undersigned decides to vary either the date or the amount of the wire, check or journal, the undersigned hereby authorizes Deutsche Bank Alex Brown to eccepi the verbal instructions from the undersigned regarding the change or changes. The undersigned further understands and agrees to comply with the procedures of Deutsche Bank Alex Brown to verify the auihonzaiion and accuracy of verbal instrucUons. csa> of fora term of Tho Lindei-sigriRd hersby acknowledges that (I) the inforntation rxiniained in this form Is complaw and accurate to the best knowledge of the undersigned; and (iij the u -idtrtsigned is responsible for the method of transmission of any rnsiructions issued pursuant to this authorization. If the undersigned elects to transmit any such ir'siiuctrons via fax tindudir>g deskiop fax), via email or as an image attachment to email is g . asa PDF, TIF or other image of such instructionsh the undersigned understands and agrees that the undei signed beers the nsk of loss arising from such memod of transmission in the event of transmission errors, .misundei standings impersonations, transmission by unauthorized person:!, forgery or intercepts For trusls or other entities, the undersigned further acknowledges that the undersigf'ed is authorized to issue the above asset movemeni insii Lu;ifOno undei the terms of the governing dDcumenis and any applicablB laws The undersiigood hereby releases and holds harmless Deutsche Bank Alex. Brown from and against loss from any acuon, claim or demand of any person as 0 result of Deutsche Bonk Alex. Brown's receipt of or compliance with this authorization and/or any mstrLiciions that may be given to Dfeuische Bank Alex. Brown pursuant fo this auihorizaiion (including any standing authonzationj EFTA01402451 The undersigned understands that Deutsche Bank Alex. Brown may. but is rtot required to. seek venfication of the undersigned's instructions by call back and that Deutsche Bank Afex Brown rrtav in its sola discretion refuse to execute such instructions (ir^cluding starKling msiructions) given pursuant to this authorization, without irreurring any liabiliiy, if Deutsche BankAfex. Brown has meson to believe such instructions (or standing instructions^ have not been provided by the undersigned The undersigned further understands Ihat^utsche fenk/Wx, Brown retains the right to refuse to eKscuie any instructions 10 uansfer funds or socuritws to any accour^tfs) pu to this duthonzation wUhou4wJiuen bearing original signaturets) of Iho undersigned barren Indyka ii 12-29-2015 3.4.A Fritu Name Date P/irl Name Dale Signaiuro LOA (0-PW)y1-0177S (17/101 High Risk Medla-CaUbackVerffiotlon Bl^Fav fLEimU Indemnification Agreement on file Signature Verified Verified Account has sufficient cash p Transaction consistent w/expected activity Method of Initiation! Recipient of Oient Instructions; Approver/ Callback QSlgnatu re Verified ^Caller Authenticated pi Verified Account/Amount/Redplent f]a.rr Cf\ Date: \t Z*, aient/Auth Signatory: Phone#; Name(Prin«phif 0. P^i'f^^m^r^ ^Recipient Slg^W^^ Appi^^^teAkSSnature . Time: 4-^tifM D EFTA01402452