EFTA01343945.pdf

Account Transfer Form I. RECEIVING FIRM INFORMATION (Only one per form) RECEIVING FIRM CLEARING NUMBER. ACCOUNT NUMBER: or TAXPAYER SOCIAL SECURITY IDENTIFICATION NUMBER NUMBER: SECONDARY SOCIAL or TAXPAYER SECURITY NUMBER: - FF1- IDENTIFICATION NUMBER: ACCOUNT TYPE: (Enter the two character code) R Nonratuemeni. SN—(Singiei JT—IJoint) TR —(Twen CT-1Coirustee) CO-(Corporate) CU —(Custodian) ES —IEstate) BC —(Bank Custody) AG —(Agency) Retirement. IR —I Iraditional IRA' RI-(Roth IRA, DR —(Direct Rollover) RI —IBeneliciary) BR —(Beneliciary Roth IRA) 4K —(401k) El —(Education Savings Account) SI —ISIMPLE IRA) QP—(Qualified Plan) 4B —(403b) 78—(457 Plan) HS-114eallh Savings Account) 5P-(529 Plan) Other. OT — !Other) II. DELIVERING ACCOUNT INFORMATION CLEARING NUMBER: ACCOUNT NUMBER: DELIVERING FIRM CONTACT INFORMATION (MANDATORY WHEN CLEARING NUMBER IS NOT PROVIDED) FIRM NAME JPMorgan Chase Bank, N.A. CONTACT NAME: ACCOUNT TITLE: (As it appears on your statement) FIRM ADDRESS. (No PO Box) The Haze Trust CITY: STATE: ZIP. TELEPHONE NUMBER: NOTE: A complete copy of yet. - 1 statement is necessary to process this form. III. TRANSFER TYPE (Choose only one) A ACCOUNT TRANSFER U FULL 'Check one below) ❑ TRANSFER ALL ASSETS IN KIND (Skip to Seclion VII U LIQUIDAI E ALL ASSETS LISTED IN SECTION IV (Lquicielions are not for brokerage accounts) U TRANSFER ALL ASSE IS IN KIND EXCEPT FOR THE ASSETS USTED IN SECTION N. WHICH REQUIRE LIQUIDATION U PARTIAL (Complete Section M B. DRS/DRIP U FULL (Check one below) U SELL FRACTIONS AND CLOSE ACCOUNT 0 TRANSFER ALL FULL SHARES ONLY U PARIIAL (List assets in Section NI NOTE: For transfer agents. electronically send positions Of issue a certificate for whole shares and redeem fractional shares. C. DIRECT MUTUAL FUND LI TRANSFER MUTUAL FUNDS FROM THE ACCOUNT HELD DIRECILY AI THE FUND COMPANY 'See list in Section IV for exact instructions) NOTE: Only one fund family per form. D. BANK RETIREMENT PLAN ACCOUNTS (Select only one) ❑ LIQUIDATE iMMEGiAt ELY AND TRANSFER CASH I am aware of and acknowledge any penalty I will incur from an early withdraws. O LIQUIDATE Af MATURITY AND TRANSFER CASH Sootily maturity dale (submit two to litree weeks before maturity date). NOTE: Liquidations involving bank CDs. checking accounts, or savings accounts can only be processed Irorn retirement accounts. SIGNATURE DATE ul 111 SIGNATURE DATE BPD 150 ACAT u9 WiTA-0697 NOM Page 2 of 3 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0028930 CONFIDENTIAL SONY GM_00175114 EFTA01343945