EFTA01580467.pdf

Funds Transfer Request (Please Type insinicsons) J.P. Morgan Lars v el Effective Dale: 11/29/12 Please enter current or rutore slate Gray Select Appropicte Payment Type and Fields wif be Displayed 0 JPMC Transfer O ACH C) Check O Domestic Wire O International Wre Principal: 6125,000.00 Income: . • n?:arfg..71Str T./ Debit Account N: 739110438 Debit Account Tale: Jelfrey E. Epstein (7 2.7.XPR Won -Z.1151' WW4W T I ,373129WaVeatifr$ retwi iikt!& '"5.ett.- ArkaAiXA-Kaitiarn.4 .$•1 -.44r,t Address 1: Receiving Bank ABA: 060004367 25 West Fleeter Street Receiving Bank Name: City National Bank of Florida Address 2: Beneficiary Account N: 1753864696 Beneficiary Name: Fowler White Burnett PA , Trust AC City: Miami State: FL Zip Code: 33130 Account Type: DDA (US) 0 Swift 0 Other Intermidiary Bank AccounUCode: Intermediary Bank Name: ry.Kg4..:Thrit Payment Details (Reference/ Advice Description/Addenda) Per Settlement Agreement and Mutual General Release 11/29/12 L Autho ized By Date ID 036211297570121 DATE: 11/29/7017 17 21M7o9kt 2 of 2 olo751/3993691/21089PIDEX1 INDEX2 PAGE 2 OF 2 Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00059806 EFTA01580467