Deutsche Bank
Private Wealth Management
Authorization for Asset Movement
For Non-Retirement Accounts
The undersigned hereby authorizes and directs Deutsche Benk Alex. Brawn
('Deuleche Bank Alex Brown" or *DBAB*) to follow the below asset movement
instructions
If you wish to request multiple wires, checks, journals or free deSvenes,
please use the long form.
DBAB Account Name; ..1«ftr9V E pvtaln
Account #: 35266676
Journal
Q Journal Funds in the amount of S
Q Journal Holdings:
Oty/Symbol/Sacunty:
Oty/Symtx)l/Securitv
❑ Journal All Holdings
To DBAB Account <
Account Neme;
Wire
Q Wire federal funds In the amount of i 1.W9
To Bank Name: Bank of America
City / State:
026009593
ABAf-
diary Hnandal Inatfludon (Optionan
Further credit to li
Account#
Name
Uhenata Banffdar Mamatfon;
lUfffcvYiium.
Accounto:
AddmnallnaiuctiDnS'
898039270903
FreaDeMriaa
❑ Pleasa deliver the secumiesindicaied below to:
DTCC#
Name of Heceiving Firm:
Account Name:
OiHk
0 Issue a check In the amount of $
Raopnnlb None
Raopieiil's Madng Addieaa:
payable to:
at Receiving ^im
Account Number:
Qty/Symbol/Secunty:
EFTA01402157
Oty/Symbol/SecurUy:
SandhgAiahottiaiiBi
Q The undersigned hereby requests that tins authorization act es a standing
authorization. The undersigned underaiands end agrees that this
euthorization win
remain In effect until Deuischa Bank Alex. Brown raquesia e new
aulhoiizaiion. The undarsignad authoiizes Deutsche Benk Alex. Bimm to leave
the wire,
check or journal on theday offor a term of
❑ The uodanrfgned further authoriias Deutsche Bank Afex. Brown » accept
verbal mitruclions from the undeiligned to wire funds, issue checks or
Journel
funds to/fiom the ebove lisied e000unu. The undersigrud will provide verbel
instruoiions es to the dste end the emouni of the wire, check or journal. II
the
undersigned decides to vary either the dele or the emount of the wire, check
or journal. the undersigned hereby authorizes Deulsche Bank Alex. Brown to
accept the verbal Insiiuctions from the undersigned regarding the change or
changes. The
procedures of Deutsche Benk Alex. Brown w verify the authorization and
accuracy ol verbel insiructione.
I further underaiands and agrees to comply with lha
The undersigned hereby acknowledges Ihst fi) the information contelnad in
this form Is oomplele and aocurete to the best knowledge ol the undarsignad;
and M the
undersgned Is responsible for the method of irenimission of any instructions
issued puisuant to tius authorization. K the undersigned electa to transmit
any etwh
insiiuciions vie fax (includti^ desktop fax), vis emeil or as an imega
auschimm lo email le.g. as a PDF. TIF or other image ol such xistrucfions),
the undersigned
understands and agrees that the undarngned beers the riA of loss enstng from
luch method ol liansmisslon in the event of transmasnn amors,
misunderstandings.
impersonations, transmissioo by unsulhonzed persons, loigery or intercepts.
For busts or other enliliea. the undersigned further acknowledges that the
undersigned is
authorized lo issue the above esiet movement instruct ons under the terms ol
the governing documents end any applicable laws. The undersigned hereby
releases end
holds harmless Deutsche Bank Alex. Blown from end againsi loss from any
action, claim or demand of any person as a result of Deuleche Bank Alex.
Brown'e raceipl of
or complienoe with this euthorizetxyn endfot eny insirucions that may be
given to Deutsche Benk Alex Brawn puisuani to this euthorization (including
any standing
aulhorizauoni
The undersigned understands that Deutsche Bank Alex. Blown rosy, but Is not
required to. seek verirxaition of the undersigned's inslrucl'ioni bycsH bock
end that
. . . cixynsj given pursuant to this euthoniaiion, without
EFTA01402158
ineurnng eny kabihly, if Ooutsehe Benk Alex. Brown has reason to bokeve such
instructions (or siending insltoclions) have nm been provided by (he
undersigned The
undersigned further understands Ihst Deutsche Benk Alex Brown telalna the
right to refuse to execute eny Instructions to lisnsfer funds or securities
to sny accounKsl
pursuant lo this aulhonzalion without wntlen inilrucliona beanng origtnal
signelurets) of the undeisrgned.
j " Darren K Indyke
Deutsche Benk Atex. Brown rnny in its sole discietian refuse to execute iuch
instructions (inciudmg si
11-04-15
ijpiSula
Print Name
Pnni Name
10-PWM-(H77S(12f10j
EFTA01402159