Deutsche Bank
Private Wealth Management
Authorization for Asset Movement
For Non-Retirement Accounts
The undereigned hereby authorizes and directs Deutsche Bank Alex. Brown
("Deutsche Bank Alex. Brown" or "DBAB") to follow the below asset movement
rnstruciions.
If you wish to request multiple wires, checks, journals or free deliveries,
please use the long form.
DBAB Accou • ffrey E EpSteln
Account #:
Journal
Q Journal Funds in the amount of S
Q Journal Holdings:
QtY/SYmbol/Seourity;
Qty/Symbol/Secunty:
❑ Journal All Holdings
To DBAB Account #:
Wire
Wire federal lunds in the amount of $ 3500
To Bank Name: TD Bank
City / State:
ABA *•.
031101266
Further cfodh to Intermediary Financial Institution (Optional)
Account #m
Name:
Account Name:
UhinateBenefioiaryhifai I nation;
RflnnfiriaivNfln.=
A000unl#:
Instnjctkms:
FteeDaGvaies
Q Please deliver the secunties indicated below to:
DTCC#:
Name of Receiving Firm:
Otack
❑ Issue a check In the amount of $
Baopienl's Name:
Beopieni's NlaiinQ Address -
Account Name:
payable id:
Account Number:
at Receiving Firm
Oly/Symbol/Sacurity:
Qty/Sym boi/Securily:
EFTA01400560
Stanfing Authnizatian
Q The undersigned hereby requests that this authorization act as a standing
authorization. Tha undersigned understands and agrees that this
authorization will
remain in effect until Deutsche Bank Alex. Blown requests a new
suihorizaiion, The undersigned authorizes Deutsche Bank Alex. Brown to issue
the wire,
check or journal on the
Q The undersigned further authorizes Deutsche Bank Alex, Brown to accept
verbal instructions from the undersigned to wire funds, issue checks or
journal
lunds to/from the above listed accounts. The undersigned will provide verbal
instructions as to tha dale end the amount of the wire, check or journal. It
the
undersigned decides to vary either the date or the amount ol the wire, check
or journal, the undersigned hereby authorizes Deutsche Bank Alex. Brown to
accept the verbal instructions from the undersigned regarding the change or
changes. The undersigned further understands and agrees to comply with the
procedures ol Deutsche Bank Alex. Brown to verify the aulhonzailon and
accuracy ol verbal instructions.
day of
for a term of
The undersigned hereby acknowledges that (I) the information contained in
this form is complete and accurate to the best knowledge of the undersigned:
and fii) 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 (c.g., as a PDF, TIF or other image of such
instructions), the undersigned
understands and agrees that the undersigned bears the nsk of loss arising
from such method of transmission in the event of transmission errors,
misunderstandings,
impersonations, transmission by unauthorized persons, forgery or intercepts.
For trusts or other entities, the undersigned further acknowledges that the
undersigned is
authorized to issue the above asset movement instructions under the terms of
the governing documents and any applicable laws. The undersigned hereby
releases and
holds harmless Deutsche Bank Alex. Brown from and against toss from any
action, claim or demand ol any person as a result of Deutsche Bank Alex.
Brown's receipt ol
or compliance with this authonzatJon and/or any instructions that may be
given to Deutsche Bank Alex. Brown puisuanl to this authorization (including
any standing
authonzalion).
The undersigned understands that Deutsche Bank Alex. Brown may, but is not
required to, seek verilicalion of the undersigned's instructions by call
back and that
EFTA01400561
Deutsche Bank Alex. Brown may in Its sole discretion refuse to execute such
instructions (including standing instructions) given pursuant to this
authonzalion, without
incuning any liability, if Deutsche Bank Alex. Brown has reason to believe
such instructions (or standing insirucitons) have not been provided by the
undersigned. The
undersigned further understands that Deutsche Bank Alex. Brown retains the
right to refuse to execute any insiruciions to transfer funds or securities
to any accounKsl
pmsuant to this authorization without i"ten inst"tion" bearing original
signature(s) of the undersigned.
^ k Darren K Indyke
5-27-2014
Print Name
Signature
Date
Pnni Name
Signature
Date
LOA
10-PWM-01775 (12/10)
EFTA01400562