EFTA01580193.pdf

Funds Transfer Request (Please Type Insts.cdoney J.1'.Morgan ft xitff"'5V- •?V re:ltf •. ?Tr - . Effective Date: 07/02/13 Please enter current or future date only Select Appropiate Payment Type and Fields will be Displayed O JPMC Transfer O ACH O Check 0 Domestic Wire O International Wire Principal: 31,015.00 tricorns: MOnator4 Debit Account 9: Debit Account Title Jeffrey E. Epstein Address I: Receiving Bank ABA: Receiving Bank Name: Bar* of America Address 2. Beneficiary Account N: Beneficiary Name: Terra Luna Yachting Ire. State: Zip Code: Intermidiary Bank Account/Code: Intermediary Bank Name: Payment Details (Reference/Advice Description/Addenda) Reimbursement of Sep 2013 Health Insurance Premium 07/02/13 Authorized Date ID: 036307028825609 DATE 07/02/2013 21 00 00 Page 0 of 4 DID: 8887316607 CSID: INDEX/: INDEX? Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00059472 EFTA01580193