EFTA01386965.pdf

1 First Bank Transfer Application BRANCH NO. PREFIX TEST KEY DATE TIME TRANSFER TYPE: ID WIRE O CABLE O DRAFT O Mail to Customer O Mall to Payee I: Send to Branch TMODIFY REP SIGNATURES (Complete appr date boxes): KEY MODIFY APPROVE IF TRANSFERRING FOREIGN CURRENCY: CONTRACT NO VALUE DATE CONVERSION RATE CONVERTED BY (Initials) TRANSFER AMOUNT (FOR BANK USE ONLY) FOREIGN CURRENCY (Type and Amount) TRADER'S NAME U.S. DOLLARS $ 52,500.00 MOTEL • Eamon currency anoint muMplied by the exchange rate =US. dollar Amount. ADDITIONAL FEES $ • U.S. Dollar amount divided by the exchange RN 2 Resign Currency Amount. TOTAL AMOUNT $ — 1 METHOD OF PAYMENT: INTERMEDIARY CORRESPONDENT BANK: (If necessary) DEBIT BRANCH/DEPT. NO. ABA ROUTING NO.ISWIFT CODE 717 BANK NAME J. Epstein Virgin Islands Foundation NAILING ADDRESS: ADDRESS 6100 RED HOOK QTR. B3 PHYSICAL ADDRESS: SAME CITY, STATE, ZIP CODE, COUNTRY CITY, STATE, ZIP CODE, COUNTRY ST. THOMAS, VI, 00802-1348, USA TO: PAYEEIBENEFICIARY'S BANK FOR: PAYEE/ACCOUNT OF ULTIMATE BENEFICIARY BANK CODE 021001033 BANK NAME NAME/ACCOUNT LE DEUTSCHE BANK J. Epstein Virgin Islands Foundation Inc. ADDRESS ADDRESS 345 Park Avenue, 6100 RED HOOK QTR B3 CITY, STATE, ZIP CODE. COUNTRY CITY, STATE, ZIP CODE,COUHTRY NEW YORK, NY 10154 ST. THOMAS, VI 00802 ORIGINATOR REFERENCE: BENEFICIARY REFERENCE: I I I I I I I I I I I I I I 1 1 1 SPECIAL. INSTRUCTION& (0pteneg THE UNDERSIGNED AGREES TO THE CONDITIONS ON THE REVERSE SIDE OF THIS APPLICATION . CUSTOMER'S TELEPHONE -- 7 - DATE OF APPLICATION: 912)2018 omen Signature DAVIS'S &Mare WAPPiCablel FOR BANK USE ONLY CUSTOMER'S TRANSFER REQUEST: Complete appropriate boxes) FAX 0 IN PERSON PHONE O MAIL/MESSENGER I.O. USED Marta leave blank) O Telephone/Fax agreement on file CALLBACK IF OVER $ LIMIT: il One tine only transaction By O SOoke to lime O Hold placed IN TAKEN IN BY (Print Name) INITIALS TEST KEY CALCULATED BY Of(Omni then taken kw by) INITIALS BRANCH AUTHORIZED SIGNER (Print Name) BRANCH TELEPHONE NO.. ( ) - BRANCHAUTHCRIZED SIGNATURE NNNN•2198.12OBR Paps 1 or 2 CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) DB-SDNY-0088927 CONFIDENTIAL SDNY_GM_00235111 EFTA01386965