Deutsche Bank
Private Wealth Management
IZI
Authorization for Asset Movement
For Non-Retirement Accounts
The undersigned hereby authorizes and directs Deutsche Bank Aiex. Brown
("Deutsche Bank Aiex. Brown" or "DBAB") to foiiow the beiow asset movement
instructions.
if you wish to request muitipie wires, checks, journais or free deiiveries,
piease use the Tong form.
DBAB Account Name: Jeffrey E Epsteifl
Account #:
Journal
Q Journai Funds in the amount of $
Q Journal Holdings:
Qty/Symbol/Security:
Qty/Symbol/Security:
Q Journal All Holdings
To DBAB Account #:
Account Name:
Wire
IZl Wire federal funds in the amount of $ 14.000.00
To Bank Name: Benk Of AmerlCS
City / State:
ABA#:
Further credit to Intermediary Financial Institution (Optional)
Account #:
Name:
Ultimate Beneficiar Information:
e.
ccoun
Free Deliveries
Q Please deliver the securities indicated below to:
Additional Instructions:
DTCC#:
Name of Receiving Firm:
Check
Q Issue a check in the amount of $
Recipient's Name:
Recipient's Mailing Address:
Account Name:
payable to:
Account Number:
at Receiving Firm
Qty/Symbol/Security:
EFTA01401578
Qty/Symbol/Security:
Standing Authorization
Q 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 Deutsche Bank Alex. Brown requests a new
authorization. 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 will provide verbal
instructions as to the date and the amount of the wire, check or journal. If
the
undersigned decides to vary either the date 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 further understands and agrees to comply with the
procedures of Deutsche Bank Alex. Brcwn to verify the authorization and
accuracy of 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 (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.
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 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
EFTA01401579
back and that
Deutsche Bank Alex. Brown may in its sole discretion refuse to execute such
instructions (including standing instructions) given pursuant to this
authorization, without
incurring any liability„ if Deutsche Banl^lex. Brown has reason to believe
such instructions (or standing instructions) have not been provided by the
undersigned. The
undersigned further understands that peutsche Bank Alex. Brown retains the
right to refuse to execute any instructions to transfer funds or securities
to any account(s)
pursuant to this authorization withoiAA«ritten>SBtructions bearing original
signature(s) of the undersigned.
'U
Harry Beller
1-21-2014
Print Name
Signature
Date
Print Name
Signature
Date
LOA
10-PWM-01775 (12/10)
EFTA01401580