EFTA01402897.pdf

Deutsche Bank Private Wealth Management Authorization for Asset Movement For Non-Retirement Accounts The underagnsd herebir lultwrizes and drraots Oaulscha Bank Alex. BfOMm ('Deutache Bank Alex Bimn' or 'DBAB') la foAow die below asaat mowmani inalrucMna. it you wish to raqueil muttiplB wirei. checks, journals or ime delivariei, please use the long lorm. DBAB Account NamaT Jaffray E Epatoln Account d: aS266»7‹ Journal Q Journal Funds In the amount of S Q Journal Holdings: Qly/SYmbol/Sacurity: Qty/Symbol/Secuiity: ❑ Journal All HoWinos ToDBABA000unt#: Account Name: . VMra Q Wiia federal funds in the amount of t 400 To Bank Name: BankofAWedCa City/State: OSIIPOffiW? ABA I: Further credit to Intarntodlary Rnandal Inathution (Opthma0 Account I: UWmalaDaflldkivkdiaiiiadGn: BaneBaani Name: Yulia Sillnskava Accounto. AUanralMnxlbns: ❑ Please dallver the securiiies indicated below to: DTCC#: Name of Reoaiving Firm; Account Name: Oiadc Q Issue a check in the amount of S BBdpteil'BName Hedimt'sKMnBAdilnsr payeUsto: T Bt Flaceiving Rim Account Number Qly/Symtiol/Sacunty: Qtv/Symtx)i/Socunty. EFTA01402897 80na0Aulhadiaiian Q The undeisigned hereby requests that this authonration act as a siandmg authorbatkin. The undersigned understands end agrees thei this euthotialion will remain in eifaci umH Deutsche Sank Alex. Brown tequesta a new auihcfiiaiion. The undarttgnod authontes Deutsche Bank Alax. Brown to issue iha wira, check or journal on the ❑ The undaAned lunher authomes Deutsche Bank Alex Brown to accept veibal Instructions from Iha undatiignad to wire lunds, issue checks or journal funds toflrom the aboue Bsiod e000unls. The undersioned will prouWa verbel inslruotioni as to the date and the amount of the wire, chock or journal. If the undersigned decides IQ veiy either the dele or the amount ol the wire, chock or journal, the undarsignad hereby aulhoriias Doutsche Benk Alex. Biown to accept the verbal Insmictions from the undets^ned regarding the change or changes. The undersigned further understands end agrees to comply with the procedures of Deutsche Benk /Max. Brown to verify the authorization and accurecy of verbel InstnKtians for a term of day of The undeisigned hereby acknowledges that b) the Infoimatlon oontalned in this lorm is complete end accurate to the bast knoWledga of the underiignad: and (li) the undersigned is lesoonsible for the method of Iraniinisslon of any mstiuctioni issued pursuant to this aulhonzauon. If the undersigned elects to Uansmit any such insl'ucilons via lax (including desktop faxl. vta email or as en image attachment W email (e g., as a PDF. TIF or other image of such mslrucliont). the undersigned understands and agrees that the undersigned bears Iha risk ol loss arising Irom such meihod of Irsnsmssion in the evem of Iransmiikm enors. miundersiandings, impersonations, transmission by unouthorized persons, forgery or iniarcepis. For uusis or other entities, the undersigned further acknowledges that the undersigned is authorized to Issue the shove atsot ntovemeni instructions under the terms ol the governing documents and any apphceWe lews. The undersigned hereby rateases and hold) harmless Deutsche Bank Alex. Brown Irom and against lost from any action, claim or demand ol any person as a resuh ol Dauische Bank Alex Brown's racalpi ol or compkinee with this aulhonzatian and/or any fnstrociions that may be gnien to Deutsche Bank /Uex Brown pursuant to this authorization finduding any standing Bulhorizationl. The undersigned undeistends that Deutsche Bank /Uax. Brown may, but Is not roquirad to. seek venficaiKNi ol the undersignsd's mstrucbons by call back and that Dauische Bank Alex. Brown may in Its sole dlscralxm refuse to execute such milnictions (irxituding sianding iniirucliofts) given puriuent to this EFTA01402898 aulhonteuon. without incurnng any kaMtiy, if Deutsche Bank Alex Brown has reason to beieve such intuoeuons (or standing instrucixins) have not been provided by the uodersignod. The undersigned (urther understands that Deutsche Bank Alex. Brown retains the nghi to refuse to execute any wisiiuclions to transfer funds or securities to any aocounl(s) puisusnl to this Bulhorizailon without wntlen jnsiruotions Imni^ onginal 9gr>aiuie<s) of the undeisigned ... Darren K Indyke " Pnnt Name 11/05/15 s Pnnt Name 10-PWM-0177S (t2/10) V EFTA01402899