Deutsche Bank
Private Wealth Management
Authorization for Asset Movement
For Non-Retirement Accounts
The undersigned hereby authorizes and directs Deutsche Bank Alex. Brown
("Deutsche Bank Alex. Brown" or "OBAB") to iollow the below asset movement
instructions.
11 you wish to request multipie wires, checks, lournals or free deliveries,
please use the long form
DRAB Accxjunt Name Jeffrey E Epsteln
Account #:
Wire
Journal
d Journal Funds m the amount of S
Q Journal Holdings:
Qiy/SvmholiSecufity
Qty/Symbol/Secuiity:
Q Journal All Holdings
To DBAB Account #:
Account Name'
0 Wire federal funds m the amount of S 10,000.00
To Bank Name- Citibank, NA
City / State:
ABA#
Further credit to Intermediary Financial institution (Qptionaii
Acocum #:
Name:
Ultimate BeneficiaiY Information;
BaneliciavName: Itzhak Koren
Account #-
Free Daliveriee
LI Please deliver die seounues moioated below to:
AddiUonal Instrucuons:
DTCC#:
Name of Receiving Firm.
Account Name:
Check
Q Issue a check in the amount of S
Recipient's Name:
Reapienl's Mailing Address.
payable lo:
Account Number:
at Receiving Firm
Olv/SymboirSecut ity.
OlyASyinbOl/Seairity:
EFTA01401501
Standing Authorization
Q The undeisigned hereby requesis lhal this authorization act as a standing
authoiizalion. The undersigned understands and agrees that Ihis
authorization will
remain m ellect until Deutsche Bank Aiex Brown requests a new aulhonzalion.
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
funds to/from the above listed accounts. The undersigned witi provide verbal
instructions as to the date and the amount of the wire, check or journal. If
the
undersigned decides to vary either the dale or the amount of 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 fuilher understands and agrees to comply with the
procedures of Deutsche Bank Alex Brown to verify the authorization and
accuracy of verbal instructions.
day of
for a tarm of
The undersigned liereby 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 lesponsible for the method of transmission of any
insiructions issued pursuant to this authorization. If the undeisigned
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 meihod of transmission in the event of transmission errors,
misunderstandings,
impersonations, transmission by unauthonzed persons, forgery or intercepts.
For trusts or other entities, the undersigned further acknowledges that the
undersigned rs
authorized to issue the above asset movement iiisiiucuons under the terms of
the govemmg documents and any applicable laws. The undersigned hereby
releases and
holds harmlass Deutsche Bank Alex. Brown from and against loss from any
action, claim or demand of any person as a result of Deutsche Bank Alex.
Brown's receipt of
or compliance with this authorization and/or any instructions that may be
given to Deutsche Bank Alex Brown pursuant to this authorization (including
any standing
authorization!.
The undersigned understands that Deutsche Bank Alex. Brown may, but is not
required to, seek verification of the undersigned's instructions by call
back and that
Daulscha Bank Alex, Brown may in its sola discretion refuse to exscule such
instructions lincluding standing insifuciions) given pursuant to this
EFTA01401502
authorization, without
incurnng any liability, if Deutsche Bank Alex. Brown has reason to believe
such instructions (or standing instructions) have net been provided by the
undersigned. The
undersigned further understands that Deutsche Baiik /Jex Brown retains the
right lo refuse to execute any instructions to transfer funds or secumies to
any account(s)
"Ntsuani to this authorization without written i^TiurfiSns bearing original
signature(s) of the undersigned.
Darren Indyke
2-23-2015
Prim Name
Signature
Date
Print Name
Date
Signature
LOA
10-PWM-01775 (12/10)
EFTA01401503