EFTA01465280.pdf

Deutsche Bank Private Wealth Management Authorization for Asset Movement For Non-Retirement Accounts The undersigned hereby authorizes and directs Deutsche Bank Alex. Brown ("Deutsche Bank Alex. Brown" or "DBAB") to follow the bolow asset movement instructions. If you wish to request multiple wires, checks, journals or free deliveries, please use the long form. DBAS Account Name: Southern Trust Company. Inc. Account#: 42952763 Journal Q Journal Funds in the amount of $ Q Journal Holdings: Qty/Symbol/Security: Qty/Symbol/Security: Q Journal All Holdings To DBAB Account #: Account Name: Wire Q Wire federal funds in the amount of $ 75.000.00 To Bank Name: First Bank. Puerto Rico City/Slate: ABAff: 1519 Ponce De Leon Ave. PR 00908 221571473 Further credit to Intermediary Financial Institution (Optional) Account #: Name: UlBmate Beneliciaty Inlbmiation; BeneTiciaiy Name Southern Trust Company. Inc. 721-1-099346 /kccounl#: Free Deliveries Q Please deliver the securities indicated below to: Addiltanal Inslruclions: DTCC<<: Name of Receiving Firm: Check Q Issue a check in the amount of S Recipient's Name: Recipient's Mailing Address: Account Name: EFTA01465280 payable to: Account Number: at Receiving Firm Qly/Symbot/Security: Qlv/Symbot/Securily: Standing Authorization Q The undersigned hereby requests that this authorization act as a standing authorization, the undersigned understands and agrees that this authorization will remain in effect until Deutsche Bank Alex. Brown requests a new authorization. The undersigned authorizes Deutsche Bank Alex. Brown to issue the wire, chack or journal on the Q The undersigned further authorizes Deutsche Bank Alex. Brown to accept verbal instructions from the undersigned to wire funds, issue checks or journal funds to/from the above listed accounis. The undersigned will provide verbal instructions as lo the data and the amount of the wire, check or journal. If the undersigned decides to vary either the date or the amount of the wire, check or journal, the undersigned hereby authorizes Deutsche Bank Alex. Brown to accept the verbal instructions from the undersigned regarding the change or changes. Tita undersigned further understands and agrees to comply with the procedures of Deutsche Bank Alex. Brown lo verily the authorization and accuracy of verbal instructions. day of for a term of I The undersigned hereby acknowledges that (it the information contained in this form is complete and accurate to the best knowledge of the undersigned; and (ii) the undersigned is responsible for the method of transmission of any instructions issued pursuant lo this authorization. If the undersigned elects lo transmit any such instructions via fax (including desktop (ax), via email or as an image attachment lo email (e.g., as a PDF, TIF or other image of such instruolionsi, the undersigned understands and agrees that the undersigned bears the risk of loss arising from such method o( transmission in the event of transmission errors, misunderstandings, impersonations, transmission by unauthorized persons, forgery or intercepts. For Iru.sts or other entities, the undersigned further acknowledges that the undersigned is authorized to issue the above asset movement instructions under the terms of the governing documents and any applicable laws. The undersigned hereby releases and holds harmless Deutsche Bank Alex. Brown from and against loss from any action, claim or demand of any person as a result of Deutsche Bank Alex. Brown's receipt of or compliance with this authorization and/or any instructions that may be EFTA01465281 given to Deutsche Bank Alex. Brown pursuant to this authorization (including any standing authorization). The undersigned understands that Deutsche Bank Alex. Brown may. but is not required lo. seek verification of lire undersigned's instructions by call back and that Deutsche Bank Alex. Brown may in its sole discretion refuse to execute such instructions (including standing instructions) given pursuant to this authorization, without incurring any liability, if Deutsche Bank Al": Brown has reason to believe such inslruclions (or standing instructions) have nol been provided by the undersigned. The undersigned further under - - - pursuant lo this authori/STion ^ithoufrfcritten inslruclions bearing original signatu that IJeulsche Bank Alex. Brown retains the right lo^refuso to execute any instructions to Iransler funds or securities to any account(s) 01 Prim Nome Signature / Date Signature Prim Name Date ill I 111 nil 11 III III LOA 10-PWM-01775 (12/101 EFTA01465282