EFTA01580342.pdf

Funds Transfer Request (Plle* TYPD belbuctiono) J.P.Morgan DS eflitk Antonimion. Effective Date; 03/14/13 Please enter current or Mute Salon* SoIcct Appropiate Payment Type and Fields will be Displayed JPMC Transfer 0 ACH 0 Chin* O Domestic Wire O International Wire Principal: 61.278.91 Income: Debit Account #: Address 1: Receiving Bank ABA: Receiving Bank Name. Wells Fargo Bank Address 2: Beneficiary Account A: Benefidary Name: City: State: Zip Code: Account Type: O DOA (US) Intermicliaty Bank Account/Code: Intermediary Bank Name: 4alosaAhaa Payment Detai s (Refrence/ Advice Description/Addenda) Exp. reimbursement 103/14/13 Authorized Date ID: 036303143381124 DATE: 03/10201315:49:00 Page 2012 DID: 8887316607 CS1D: INDEXI: 1N0EX2 Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00059651 EFTA01580342