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 "DBAB") to follow the below asset movemant
instructions.
If you wish to request multiple wires, cheeks, journals or free deliveries,
please use the long form.
DBAB Account Name-
Account #;
Journal
l_I Journal Funds in the amount of $
Q Journal Holdings:
Qty/Symbol/Security:
Oty/Symboi/Securlty:
Q Journal All Holdings
To DBAB Account #:
Account Name:
Wire
Q Wire federal funds in the amount of $ 10,000
To Bank Name: Bank of America
te:
Ci
ABA #:
Further credit to Intermediary Financial Institution (Optional)
Account #:
Name:
UhsnatB Beneficiary Mcmialion;
Beneficiary Narre
Account#:
Free Deirvarias
LI Please deliver the securities Indicated below to:
Additional Instructions:
DTCC#
Name of Receiving Firm:
Check
0 Issue a check in the amount of $
Recipient's Name;
Reapient's Mailing /Aress:
Account Name:
pavQbtelo:
Account Number:
at Receiving Firm
Oty/Symboi/Security:
Qty/Symbol/Secufity:
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Standfaig Auttioriialion
Q The undersigned hereby requests that this authorization act as a standing
eulhorization. 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 /\iex. 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 o( Deutsche Bank Alex. Brown to verify the authorization and
accuracy of verbal instructions
day of
for a term of
The unCersigned heieby acknowledges that (i) the information contained in
this form Is complete and accurate to the best knowledge of the undersigned;
and (li) 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 le.g„ as a PDF, TIF or other image of such
instructions), the undersigned
understands and agrees that the undersigned beers the risk of loss arising
from such method of transmission in the event of transmission errors,
misunderstandings.
impersonations, transmission by unauthorized j3ersons, 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 undeistands that Oeutschs Bank Alex. Biown may, but is not
required to, eeek venTiatiDn of ttw undersigned's inslniciianE by call back
and that
Deutsche Bank Alex. Bniwn mayin Its sole discreikm refuse to execute sich
EFTA01404626
instructions (including slending ktsUuaionBl given punuam to Ih'n
aulhoiization, without
incuirtng any tebililY, if Deutsche Benk Alex, Brown has reason to believe
such insiruclions (or standing msirucuons) have not b<<n piovided by the
undersigned. The
undersigned further understands that Deutsche Benk nuns the tight to refuse
to execute any insinictions to transfer funds or securities to any e000unKs]
otj"uam to this authoriiation with^ wri^ hstnrcliepS^nng anginal
signature(s) of the undersigned.
K Indykd
12-17-14
Print Name
SiO
Date
Print Name
Signature
Date
III I III III I nil III
LOA
10-PWM-0177S (12/10)
EFTA01404627