EFTA01580168.pdf

Funds Transfer Request (Please Type Instructions) J.P.Morgan Effective Date: 07/19/13 Please enter current w future date only Select Appropiate Payment Type and Fields will be Displayed O JPMC Transfer O ACH O Check O Domestic Wire O International Wire $50,01)0.00 Innerrei Debit Account #: Cait Account Title: ' 14r :6 Address 1: Receiving Bank ABA: 121000248 Receiving Bank Name: Wells Fargo Bank Address 2: Beneficiary Accounts: 94 24 Beneficiary Name: Black Srebnick Kornspan & Stumpf Tr City: State: Zip Code: Account Type: O Swift O Other Intermidiary Bank Account/Code: Intermediary Bank Name: Payment Details (Reference/ Advice Description/Addenda) 07[19/13 Authorized By Date Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00059442 EFTA01580168