Funds Transfer Request (Plana TYlwr Ihirrdethrit)
ti.P Morgan
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Effective Date: 05/28113
Plaice whir curront n luks. dato any
Select Appropiate Payment Typo and Fields veil; be Displayed
JPMC Transfec Q ACH 0 Check 0 Domestic Wire O International Wire
Principal: $10,000.00
Address t:
Receiving Bank ABA:
Receiving Bank Name' Address
Beneficiary Account*:
Beneficiary Name'
Account Type 0 ODA (OS) 0 Other
hitcnnidiary Bank
Account/Code:
Payment Details (Reference/Advice Description/Addenda)
(0.5!28!13
Authorized By Date
ID: DATE:051281201313 lOppa%2 of 2 DI : EX1: INDEX2: PAGE 2 OF 2
Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00059529
EFTA01580238