EFTA01415136
EFTA01415137 DataSet-10
EFTA01415140

EFTA01415137.pdf

DataSet-10 3 pages 631 words document
P17 V15 V16 P19 V11
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Authorization for Non-USD Wires For Non-Retirement Accounts The undersigned hereby authorizes and directs Deutsche Bank Securities Inc. (DBSI) to follow the below asset movement instructions. Account Number DBSI Account Name 1. Non-USD Wire Currency/Amount: Bank Information: SWIFT ID/BIC: To Bank Name: City: 3. Ultimate Beneficiary Information (required) Beneficiary Name: Second Beneficiary Name: IBAN/Account #: Additional Instructions: 2. Second Bank Information (if applicable) SWIFT ID/BIC: To Bank Name: City: Country: Account #: Further credit to Intermediary Financial Institution (if applicable) Account #: Name: Standing Authorization: Checking both boxes allows you to verbally vary instructions set forth in box A. A 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 DBSI requests a new authorization or DBSI receives notice of the revocation of these instructions. The undersigned authorizes DBSI to issue the wire on the 15 months of non-use. B The undersigned further authorizes DBSI to accept verbal or electronic instructions from the undersigned to wire funds to/from the above listed account(s). The undersigned will provide verbal or electronic instructions as to the date and the amount of the wire. PLEASE NOTE: The undersigned understands and agrees to comply with the procedures of DBSI to verify the authorization and accuracy of verbal or electronic instructions. WM179313 011507.120117 Page 1 of 2 day of until otherwise instructed. This authorization will expire after DBLOATRF EFTA01415137 The undersigned hereby acknowledges that (i) 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 to this authorization. If the undersigned elects to transmit any such instructions via fax (including desktop fax), via email or as an image attachment to email (e.g., as a PDF, TIF or other image of such instructions), the undersigned understands and agrees that the undersigned bears the risk of loss arising from such method of transmission in the event of transmission errors, misunderstandings, impersonations, transmission by unauthorized persons, forgery or intercepts. The undersigned hereby releases and holds harmless DBSI from and against loss from any action, claim or demand of any person as a result of DBSI's receipt of or compliance with this authorization and/or any instructions that may be given to DBSI pursuant to this authorization (including any standing authorization). For trusts or other entities or agents acting on behalf of Client, the undersigned acknowledges that the undersigned is authorized on behalf of Client to enter into this authorization and issue the instructions under the terms of the governing documents and any applicable laws. The undersigned understands that DBSI may, but is not required to, seek verification of the undersigned's instructions by call back and that DBSI may in its sole discretion refuse to execute such instructions (including standing instructions) given pursuant to this authorization, without incurring any liability, if DBSI has reason to believe such instructions (or standing instructions) have not been provided by the undersigned. The undersigned understands that DBSI retains the right to refuse to execute any instructions to transfer funds or securities to any account(s) pursuant to this authorization without written instructions bearing original signature(s) of the undersigned. Further, the undersigned acknowledges that DBSI shall be entitled to rely on the authorization until actual receipt by DBSI of notice of: (i) Client's or the undersigned's revocation of the instructions or (ii) the death or legal incapacity of Client (if Client is a natural person) or the undersigned. Signature Signature Print Name Print Name Date Date 0 2017 Deutsche Bank AG. All rights reserved. WM179313 011507.120117 On On Warszawa Ref: SOFL Deutsche Bank Polska SA PL89188000090000001370003035 EFTA01415138 DEUTPLPX DEUTGB2L PLN / 3,982,916.26 Deutsche Bank AG, London N4Gxxx804 SOUTHERN FINANCIAL LLC EFTA01415139
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SHA-256
a0d410de1b67be86a20597aba4ae7723df09e85c6c6451e3e769e3c0a36f8402
Bates Number
EFTA01415137
Dataset
DataSet-10
Document Type
document
Pages
3

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