EFTA01580454.pdf

Funds Transfer Request (Reim Typo Iii5Itutturcs) J. P. N40 rgan Ft:kit Effective Dato: 12/06/12 Pl.a se enter current er future au only Select Appropiate Payment Type and Fields wilt be Displayed O JPMC Transfer 0 ACH 0 Check C) Domestic Wire intematonal Wire Principal $1,321.00 Incomp: Address 1: Receiving Bank ABA: 4608 Tula Park Mall Receiving Bank Name. Merchants Commercial Bank a/c8 021000742 Address 2: Beneficiary Account it: Beneficiary Name: Kellerhals Ferguson Fletcher LLP City: St Thomas USVI State: Zip Code: V tit.. X Account Type: C) Swift intermiciary Bark 121042484 Account/Code: Intermediary Bank Name: Pacific Coast Bankers Bank iftå Payment Details (Reference! Advice Description/Addenda) GCS LW Formation Costs & STC Business License Costs I12106`12 I • Authorized By Date ID. C36212067806841 DATE 12/0620121758W pagd 3 of 3 DID'ABUS4613{75,9)Q) II1DEX1 I N DEX2 PAGE 3 OF 3 Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00059790 EFTA01580454