EFTA01580051.pdf

Nov-27-2013 04:03 PM JPMorgan Chase 302-634-5580 2/2 Funds Transfer Request (Please Type Instructions) JPMorgan b t-fkgt: h&c .1;.11-y-ra r Effective Date: 11/27/13 Please enter current or future date only Select Appropiate Payment Type and Fields will be Displayed 0 JPMC Transfer 0 ACH 0 Check O Domestic Wire 0 International Wire Principal: $0.12 Income: On 'iattoS 715 S•ta Debit Account Debit Account Title: 'The Haze Trust Address 1: Receiving Bank ABA: Receiving Bank Name Bank of New York J Address 2: Beneficiary Account if: Pershing LLC Beneficiary Name: City: I State: Zip Code: rc•-t:Ax 5 `1•:•!, :r1tWai...741(f4:::: e... . - .,..,;stk;0514,,Ster/ 11t7AtQl.:1:0•?.?P' Account Type: 0 DDA (US) 0 Swift 0 Other Intermediary Bank Account/Code: Intermediary Bank Name: Payment Details (Reference/Description/Addenda) F/F/C NC $ N4G024943 NC Name: The Haze Trust Authorized 11/27/13 Date Authorized By CIS e5c.Eftcy e et,1111 5;2-5 Stc-c7 / ,-126N C14 Vron ID: 0363112M707715 gthritS7/2Ife2gto Rags 2d 2 DID: 8887316607 CSID: 302-634-5580 INDEXI: INDEX2: Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00059287 EFTA01580051