EFTA00165888.pdf

AUTHORIZATION OF POWER OF ATTORNEY For Natural/Individual Persons For Brokerage Accounts and/or retirement accounts with DBSI This Authorization/Power of Attorney constitutes a non-durable limitedpower of attorney, designed to give a person or persons designated by you either 1) limited authority over your Account(s) or (2) full authority over your Account(s) as set forth below. NOTE: UNDER NEW YORK LAW, THE FOLLOWING DISCLOSURE IS REQUIRED TO BE INCLUDED, VERBATIM, IN EVERY POWER OF ATTORNEY. CAUTION TO THE PRINCIPAL: Your Power of Attorney is an important document. As the "Principal," you give the person whom you choose (your "agent") authority to spend your money and senor dispose of your property during your lifetime without telling you. You do not lose your authority to act even though you have given your agent similar authority. When your agent exercises this authority, he or she must act according to any instructions you have provided or, when there are no specific instructions, in your best interest "Important Information for the Agent" at the end of this document describes your agent's responsibilities. Your agent can act on your behalf only after signing the Power of Attorney before a notary public. You can request information from your agent at any time. If you are revoking a prior Power of Attorney by executing this Power of Attorney, you should provide written notice of tha revocation to your prior agent(s) and to the financial institutions where your accounts are located. You can revoke or terminate your Power of Attorney at any time for any reason as long as you are of sound mind. If you are no longer of sound mind, a court can remove an agent for eating improperly. Your agent cannot make health care deeisions for you. You may execute a "Health Cam Proxy" to do this. The law governing Powers of Attorney is contained in the New York General Obligations Law, Article 5, Title 15. This law is available at a law library, or online through the New York State Senate or Assembly websites, www.sonate:state.ny.us or www.assembly.state.ny.us. If there is anything in this document that you do not understand, you should consult with your lawyer. AUTHORITY The u ersignel Principal (the "Undersigned" or "Principal") hereby appoints: fir 0O; v- or ,pis „e as the Undersigned's agands) and attorneys) in-fact ( ent(s)") to act INDIVIDUALLY with respect to any and all accounts, if applicable (see below) in the Undersigned's name ("Account(s)"), held individually or jointly (provided that all joint account holders have executed this font) with DBSI, as well as individual retirement accounts held for the benefit of the Undersigned ("IRAs"), with the authority to direct DBSI to buy, sell (including short sales) and otherwise transact in any security, including but not limited to stocks, bonds, mutual fund shares, limited partnership interests, call and put options (covered and uncovered), en margin or otherwise, and any instrument, agreement or contract relating to same, on margin or otherwise, or enter into futures, options on futures and forward contracts, interest rate, currency, equity or commodity swap transactions, deposit accounts at financial institutions and direct or indirect interests in securities, deposit instruments or contracts where all or part of the return is calculated by reference to changes in, among other things, the value of securities, commodities, currencies, interest rates, property of any description or indices, in each case in accordance with ()BSI's terms and conditions for the Undersigned's account, account type, and risk and in the Undersigned's names. or number(s) on DBSI's books. Agent(s) must exercise the authority granted herein pursuant to the Undersigned's instructions, or otherwise for purposes which the Agent(s) reasonably deems to be in the Undersigned's best interest. By giving this authority, the Undersigned authorizes Agent(s) to make inquiries on the Account(s), including requesting information about account transactions, balances and holdings. 1018aseacto 11PM/0985(01/121 009611-010512 CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0001636 EFTA_000 15 I 10 EFTA00165888  Principal agrees that DBSI shall not be obligated to proceed with instructions that are inconsistent with the terms of any agreements governing the Account(s), or that would violate any applicable laws, rules or regulations, or that would be otherwise limited by the account type or documentation on file. THE UNDERSIGNED AUTHORIZES THE AGENT(S) TO RECEIVE COPIES OF ACCOUNT STATEMENTS AND TRANSACTION CONFIRMATIONS UPON THE AGENT(S)'S REQUEST. DBSI RETAINS THE RIGHT IN ITS SOLE DISCRETION TO REFUSE TO ACCEPT INSTRUCTIONS BY THE AGENT(S) TO CHANGE THE MAILING ADDRESS ASSIGNED TO THE UNDERSIGNED'S ACCOUNT(S) OR ANY BENEFICIARY DESIGNATIONS. NOTE: If you want to authorize your Agent(s) to make gifts of your money or assets or other property held in the Account(s) during your lifetime, without restriction, to any one or more persons, including the Agent(s) himself, herself or themselves, you will need to execute a Statutory Major Gifts Rider. Giving such a power to your Agent(s) grants your Agent(s) authority to take actions whidh could significantly reduce your property or change how your property is distributed at death. DRS' shall not be responsible to monitor whether any payments or transfers are gifts and/or require the execution of a Statutory Major Gifts Rider. SELECT AND INITIAL THE APPLICABLE BOX FOR LIMITED OR FULL TRADING AUTHORIZATION O LIMITED TRADING AUTHORIZATION. In all such purchases, safes or trades, DBSI is rnwp authorized to follow the instructions of Agent(s) in every respect concerning the Account(s), add Agent(s) is/are authorized to act for the Undersigned and on the Undersigned's behalf in the same manner and with the same force and effect as the Undersigned might or could do with respect to such purchases, sales or trades as well es with respect to all other things necessary or incidental to the furtherance or conduct of such purchases, sales or trades. Note: This Limited Authorization does not permit Agenffs) to withdraw or transfer assets from the Account(s). — OR — L/ /7 f3 FULL AUTHORIZATION TO TRADE AND MOVE ASSETS. DBSI is authorized to follow the /imam instructions of Agent(s) in every respect concerning the Account(s), and to make deliveries or transfers of assets (including cash), from the Account(s) and payment of moneys as directed by Agent(s), without restriction froseludingicedureagent(ef; himself, herself or themselves except in connection with IRAsI in accordance with DBSI's terms and conditions and account type. In all matters and things aforementioned, as well as in another things necessary or incidental to the furtherance or conduct of the Accoura(s), Agenffs) may act in the same manner and with the same force and effect as the Undersigned might or could do. Note: This Full Authorization grants Agentls) unrestricted authority to trade in the Account(s) and to withdraw or transfer assets from the Account(s). For IRAs. Agent is authorized to elect whether to make tax withholding elections in connection with distributions. This Authorization/Power of Attorney shall remain in full force and effect until DBSI receives actual written notice signed by the Undersigned of its revocation to be delivered to the Undersigned's DBSI Client Advisor or his or her branch manager. However, the limited power of attorney granted hereunder is mg a durable power of attorney and will cease to be effective upon actual receipt by DBSI of written notice of the occurrence of either of the following events: (i) the Undersigned is judicially declared to be incompetent, or (ii) the death of the Undersigned. Notwithstanding the foregoing, the Undersigned acknowledges that DBSI shell be entitled to continue to rely upon this Authorization/Power of Attorney until such time as DBSI receives such actual written notice. 2 1 I SVVIA.098.5 (0%/13) 0096I1-010b17 CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0001637 EFTA_000 15 1 1 1 EFTA00165889  The Undersigned understands and agrees that DBSI has the right to require additional verification and documentation from the Undersigned or the Undersigned's Agent(s) in certain transactions that DBSI, in its sole discretion, deems necessary. In addition, DBSI has the right to request that either a new Authorization/ Power of Attorney be executed or that the Agent(s) verify in writing the validity of the current Authorization! Power of Attorney. Agent Name: Agent Name: i IJA-C 1 2)i -eh A.4 /I j Address: Sic Le ct adritn (1L Yft4~ Address: l/cc ,()&j 44* 11 I-1 y ice 7,1- 57. /OA f 5 , (icy/ coiktt. TIN of Agent: TIN of Agent: Relationship Relationship to Principal: 11-c.ct., ad"-, I to Principal: yr( THIS DOCUMENT DOES NOT REVOKE ANY OTHER POWERS OF ATTORNEY THAT THE UNDERSIGNED HAS PREVIOUSLY EXECUTED, UNLESS THE UNDERSIGNED HAS SPECIFIED OTHERWISE ON THE LINES BELOW. INDEMNIFICATION The Undersigned acknowledges and agrees that the Undersigned is responsible for all acts of the Agent(s). The Undersigned hereby agrees, individually and on behalf of his/her heirs, executors, legal representatives, and assigns to indemnify and hold harmless DBSI and its parents, affiliates, subsidiaries, officers, employees, and agents (collectively, "DB") from all claims that may arise in connection herewith, and to pay DB promptly, on demand, any and all losses and liabilities arising therefrom or from any action taken or not taken by DB in reliance hereon, including without limitation, any debit balance due with respect to the Aocount(s). The Undersigned further hereby ratifies and confirms any and all transactions (including any payments or transfers) made by the Undersigned's Agent(s) in connection with the Account(s) prior or subsequent to the execution of this document and holds harmless DB regarding same. This Authorization/Power of Attorney shall inure to the benefit of DB and its successors and assigns irrespective of any change or changes at any time in the personnel thereof for any cause whatsoever. The Undersigned understands and agrees that the DBSI may require joint account holder(s) to sign all requests for withdrawals from an account jointly with the Agent(s). 3 II PWM.0985101/I7) 033611.010612 CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0001638 EFTA_000 15 1 12 EFTA00165890  • • The Undersigned by signing below confirms that he/the has read the contents of this Power of Attorney and understands same, and has executed this Power of Attorney of his/her own free will and has received . advice about the effect of this Power of Attorney from his/her advisers as he/she has deemed necessary or advisable. In witness whereof, the Undersigned has executed this Autheriz ion/Power of A owe Date: 10413 Signature: Print Name: (the "Cinders TO BE EFFECTIVE FOR JOINT ACCOUNT(S), ALL ACCOUNT HOLDERS MUST SIGN: In witness whereof, the Undersigned has executed this Authorization/Power of Attorney. Date: Signature: Print Name: (the "Undersigned") This section intentionally left blank. 4 11SW1,40965 (0ll12) CO9611-010512 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0001639 EFTA_000 15 1 I 3 EFTA00165891  ACKNOWLEDGEMENT OF PRINCIPAL'S SIGNATURE IN NEW YORK STATE STATE OF NEW YORK, COUNTY OF Pe .41 yflie,k as.: On 40L34 / 41, ,.11 0. before me, /74/ty personally appeared kt- tile im personally known to me 6r proved to me on the basis of satisfactory evidence to the ind idual s) whose name(s) is (are) subscribed to within the instrument and acknowledged to me that he/she/they executed the same in his/herhheir capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon beh of whom thein v ual(s) acted, executed the instrument. HARRY I. SELLER Notary Public Notary Pudic, ;Mite of New York No 31RE4853924 ACKNOWLEDGEMENT OF PRINCIPAL'S SIGNATURE OUTSIDE NEW YORMAT-E Rack!and County j r • Commission Expires Feb. 17. 20 • STATE OF COUNTY OF ss.: On before me, personally appeared personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose names) is (are) subscribed to within the instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/ their signature(s) on the instrument, the individual(s), or the person upon behalf of whom the individual(s) acted, executed the instrument, and that such individual(s) made such appearance before the Undersigned in (state/country). (signature and office of the individual taking acknowledgement) ACKNOWLEDGEMENT OF PRINCIPAL'S SIGNATURE IN NEW YORK STATE (for joint accounts) STATE OF NEW YORK, COUNTY OF ss.: On before me, personally appeared personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to within the instrument and acknowledged to me that he/shelthey executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of whom the individuals) acted, executed the instrument. Notary Public ACKNOWLEDGEMENT OF PRINCIPAL'S SIGNATURE OUTSIDE NEW YORK STATE (for joint accounts) STATE OF , COUNTY OF ss.: On before me, personally appeared personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to within the instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/ their signature(s) on the instrument, the individual(s), or the person upon behalf of whom the individual(s) acted, executed the instrument, and that such individuafis) made such appearance before the Undersigned in (state/country). (signature and office of the individual taking acknowledgement) 5 11.PlArMA985 MI/12) CO9617-010512 CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0001640 EFTA_00015114 EFTA00165892 . • • • IMPORTANT INFORMATION FOR THE AGENT(S): When you accept the authority granted under this Authorization/Power of Attorney, a special legal relationship is created between you and the Principal. This relationship imposes on you legal responsibilities that continue until you resign or the Authorization/Power of Attorney is terminated or revoked. You must: 1. act according to any instructions from the Principal, or. where there are no instructions, in the Principal's best interest; 2. avoid conflicts that would impair your ability to act in the Principal's best interest; 3. keep the Principal's property separate and distinct from any assets you own or control, unless otherwise permitted by law; 4. keep a record of all receipts, payments, and transactions conducted for the Principal; 5. disclose your identity as an Agent whenever you act for the Principal by writing or printing the Principal's name and signing your own name as "Agent" in either of the following manner (Principal's Name) by (Your Signature) as Agent, or (Your Signature) as Agent for (Principal's Name); and 6. agree that DBSI shall not be obligated to proceed with instructions that are inconsistent with the terms of any agreements governing the Account(s) or that would violate any applicable laws, rules or regulations. You may not use the Principal's assets to benefit yourself or give major gifts to yourself or anyone else unless the Principal has specifically granted you that authority in this Authorization/Power of Attorney and in a Statutory Major Gifts Rider which the Principal may attach to this Authorization/Power of Attorney. If you have that authority, you must act according to any instructions of the Principal or, where there are no such instructions, in the Principal's best interest. You may resign by giving written notice to the Principal and to any co-agent, successor agent, or the Principal's guardian if one has been appointed. If there is anything about this document or your responsibilities that you do not understand, you should seek legal advice. Liability of Agent: The meaning of authority given to you is defined in New York's General Obligations Law, Article 5, Title 15. If it is found that you have violated the law or acted outside the authority granted to you in the Authorization/Power of Attorney, you may be liable under the law for your violation. AGENT(S)' SIGNATURE AND ACKNOWLEDGEMENT OF APPOINTMENT: It is not required that the Principal and the Agent(s) sign at the same time, nor that multiple Agents sign at the same time. I/we, - 7 /22tav have read the foregoing (insert name(s) of Agenth)I Authorization/Power of Attorney. I am/we are e person(s) identified therein as Agent(s) for e Principalyr5me therein. GA-C m Agent's signature Agekit's sig ature Dated: Dated: r:/ /fig/IS 6 11.PWM-0.5.85 (01P 2) CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0001641 EFTA_000 15 1 15 EFTA00165893  ACKNOWLEDGEMENT OF AGENT(S)' SIGNATURE IN NEW YORK STATE STATE OF NEW YORK, COUNTY OF 1...ri,..„. rr t i - ss.: On /A/ 13 before me, Rs r r7 /Vet, personalty appeared _...icer- r.. v., 6 rb It "'I...-, personally known to me or proved to me on the basis of satisfactory evidence to bethe individual(s) whose names) is (are) subscribed to within the instrument and acknowledged to me that he/she/they executed the same in his/her/their ciipacity(ies), and that by is/her/their signature(s) on the instrument, the individual(s), or the person upon bib f of torn the, tvidual(s) acted, executed the instrument. HARRY I. REELER Notary Public Notary Public, Slate of New York No 01624853924 Ouslifiod in Poc:rland County", ACKNOWLEDGEMENT OF AGENT(S)' SIGNATURE OUTSIDE NEW YORK STATgrn omission Expires Feb. 17, 20 STATE OF COUNTY OF ss.: On before me personally appeared personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to within the instrument and acknowledged to me that he/she/they executed the same in his/her/heir capacity(ies), and that by his/her/ their signature(s) on the instrument, the individual(s), or the person upon behalf of whom the individual(s) acted, executed the instrument, and that such individual(s) made such appearance before the Undersigned in (state/country). (signature and office of the individual taking acknowledgement) ACKNOWLEDGEMENT OF AGENT(S)' SIGNATURE IN NEW YORK STATE (for joint accounts) STATE OF NEW YORK, COUNTY OF Ajcpv \-/ O r ss.: On ZC1/5 before me, bias , ri personally appeared ter personally known to me or proved to me on the basis of satisfactory evidence to the in tv ual(s) whose name(s) is (are) subscribed to within the instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of whom the individual(s).acted, executed YOLANDA RICHARDSON the instrument. Notary Public. Slate of New York S-14_,VA No O I /16053071 Qualified in Queens County Notary Public comntission Expires January 2. 20.15 ACKNOWLEDGEMENT OF AGENT(S)' SIGNATURE OUTSIDE NEW YORK STATE (for joint accounts) STATE OF COUNTY OF ss.: On before me, personally appeared personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to within the instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by histher/ their signature(s) on the instrument, the individual(s), or the person upon behalf of whom the individual(s) acted, executed the instrument, and that such individual(s) made such appearance before the Undersigned in (state/country). (signature and office of the individual taking acknowledgement) 7 11-PWPA-0905(01/12) 03961I -010512 CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0001642 EFTA_00015116 EFTA00165894  r agsbieeitelsimataithireeolls.iii . W.0 'r' 1/2etSit tivikigigietragatiSiit t St likia411±e2Q.A';t:L'A 2, 4 4 BRENNAN-MEERACHT, JEAN ANNE _THOMAS, VI 00802 Issued CIS Hgt 52 in Wgit 2 Hair BRO Class A' Mood Type Allergies NONE Endorsement; Restrictions YAW • CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0001643 EFTA_00015117 EFTA00165895  rEATE: `+ CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0001644 EFFA_000 15 1 18 EFTA00165896