Text extracted via OCR from the original document. May contain errors from the scanning process.
UBS
UBS Financial Services Inc
Account Number
/
PWM Office
Power of Attorney (PWM)
(Not for use when naming a professional Investment Advisor)
. " Account Wm*
• !natal here gI itth
authorization apply to all accounts at U8S Emeriti,* Services Inc in the tame name. whether currently open or opened in
he future
•
• This unR confirm the authority of
Xio 4.1
g_estle(
(Agent Warne)
Private Wealth Advisor
Ca
to perform each of the actions initialed below and to take any and at actions necessary to or incidental to carrying out such authorizations
including the execution of documents or forms a other authorizations
: • . • Note When used in this document, the words •i•.. or 'me' or 'my' refer to each of the ckent3WprincipaKs)• inderiduaes) or entitbeSi. that
executes this Power of Attorney
ads diem mutt knit! In the box next to each agency granted. PLEASE SEE IMPORTANT DISCLOSURES REGARDING TRADING
• AUTHORIZATION FOR IJIRS PACE AM) STRATEGIC ADVISOR ACCOUNTS ON PAGES 2 AND 3
- . •
. ' Trading Authorization
. .
, ..._.... _
I initial here to authorize my Agent to enter oroers with you to purchase and Sett securities and sanitar property Including options
---
transactions), n accordance with the qualifications. eligtelity and general terms and conditions lot my acC0unl:St. as brokers or
dealers acting for my own account(s). or as brokers for some othe person
Managed Account Authorization
i initial here to authorize my Agent to enroll my account in any investment advisory program offered by U85. to execute the
Investment Advisory Relationship Agreement or applicable forms. and specifically to hat and terminate discretionary and non•
discretionary investment managers I understand that the Advisory Relationship Agreement, whether executed by me or my Agent.
win apply to all U85 advisory program accounts that I may open in the future
Disbursement Authorizations
._,
I._
AU
4
I initial here to authorize my Agent to instruct UBS to transfer money or securities to accounts held in my name or rot my benefit.
and to make tax ....unbolting electrons on my behalf in connection wan any transfer authorized under this Power of Attorney Such
transfers may be elected by methods which include but are not limited to journal entries. twice transfer, electronic funds transfer or
checks
Tax Documents Authorization
Gifin I initial here to authottae my Agent to make. execute and present tax lams. including without hmitaterm all US Internal Revenue
Service loans W-8 and W'9. as aceirCable• and any related documents
Duplicate Account inlormadon Authorization
AM
)I I initial here to authorize my Agent to receive a &plicate copy of all confirmation, statements and other COMMUntattOn5
Multiple Agents
If I have designated multi* agents to art on my account(s). I direct that each agent is authorized to act independently of any other agent, it
U85 Financial Services Inc determines, in its sole discretion, that it is (owning confhctng instructions from agents that I have designated,
authorize 1185 Financial Services Inc in its discretion to stop taking instructions horn any of my agents until the COnilkt is resolved either al my
direction a by my designated agents
pgn this section if you garnet that multiple agents must act jointly Units signed below, you authorize each agent to act separately
It I have detonated more than one agent for my accounts, I direct that U85 Financial Services Inc act only upon the pint instructions of all
desxmated agents
Client First Name
last Name
:portant!!
AC-MT Mei 12/14)
O2014 U85 Financial Services Inc All rights reserved Member
Dare
Pape 1,3
se
CONFIDENTIAL
UBSTERRAMAR00000779
EFTA00236471
SUBS
Authorized Agent/Dual Signor Addendum
Dual Signors for RMA/Business Services Account BSA Check Writing
Dual.Signature checks require two signatures at all times. If you ace designating more than two signiors and you would like one of the
signors to be required, at all twnes, please check 'Rewired* next to the signor's name Only one iricWidual can be a required Signor If you do
not designate a required signor. please specify at signors as Optianefal if the individual designated below is not a ORS Financial Services Inc client
e account holder, authorized agent. power of attorney, etc ) also complete the Authorized Agent for MA/Business Services Account BSA
Check Writing section now
E Check here if you do NOT want UBS Financial Services Inc to order new dual signature checks If checked, you wit be responsible for
obtaining checks with dual signatures VBS :manual Services Inc will not accept single signature checks
Dual Signor First Name
last Name
Dual Signor First Name
Last Name
Specify the type of signor C
Required
0
Optional
Speedy the type of signor 0
Reputed
_J Option
Sign Nene only d adding a Dual Signor
Dual Signors Signature
Date
Dual Signors Signature
Date
Now You must complete and sign a new addendum to add, remove or update dual signors VBS. Financial Services Inc will rely on the most
recently dated addendum to supercede and replace any OMIT previous dual signor addendum on lee
Account Holder Certification
Ely signing below. I UNDERSTAND. ACKNOWLEDGS AND AGREE that (1) I have reviewed al 01 the information contained in this addenckiM and
I declare it as true and accurate and (2) UEIS Financial Services Inc is authorized to rely upon the
red by this document until U8S
Financial Services Inc receives an updated cope of this form revoking or modifyrog this
Ci weir
Account Holder test Name
last Name
Act
If
sysnahve
Date
0 Account Holder fast Name
LW Name
Account Holder *Mature
01/3905603 Ili'
AC-RW (Rev 12/14)
O2014 U8S Financial Services Mc All rights eserved Member SIPC
Date
Page 2/2
CONFIDENTIAL
UBSTERRAMAR00000780
EFTA00236472
UBS
Agreement
fly signing below. I agree to indemnify and hOd harmless OBS and its affiliates and at of thee ents$0yets and agents from and against any and
del clainn that may arise by reason of UBS having relied on the provisions of this instrument I acknowledge and agree that my agent
authorized to make any trade far which my account is ekgible or approved. including margin trades and short sales and to receive any and all
account information I hereby ratify. confirm and agree to be bound by any and all transactions, trades or dealings. whether written or verbal.
effected in and for my account(s) by my agent in connection with the authority granted in this instrument. including. but not limited to. the
execution of documents. forms or agreements or any authorizations if I have instructed that this Power of Attorney be accepted in a Trust or
Business Service Account. I expressly acknowledge and Jove that, by signing below. I delegate the foregoing authority t have as Trustee or
Officer. Member, Manager, Partner or other represeNtive duly authorized, and sign this Power of Attorney in such reeveSentatwe capacity or
capacities as applicable for the accounts to which this authorization applies
This Power of Attorney wan be subrect to, controlled by and interpreted in accordance win the laws of the Mate of New Yolk, without giving
effect to any principles of choice of law or conflict of taws (notwithstanding any provision to the contrary contained in any apctication for any
account at UBS or in any other document;
U0S n entitled to rely on this Power of Attorney until written notice of its revocation is delivered no the branch office where the attounl is
maintained and retool is acknowledged by UBS. Enrollment in discretionary UBS Investment Advisory programs win, for those
accounts, immediately and effectively mink, any trading authorization granted herein. In addition. some of the ServiCeS you have
selected may be subject to limitations on their availability as required by law. regular on, rule or our pobcies, and under those arcumslan(es,
these services may be terminated or declined in UBS' sole discretion. For example, UBS Financial Advisors cannot be appointed Power of
Attorney In any redrement account.
This is an important legal document. Before executing this document you should know these important facts:
•
This document may provide the person you designate as your agent/artoiney.inifect with broad powers, including power to
manage, sell. dispose of the assets in your account or borrow money owl., your property es security for the loan.
•
If you are using this Power of Attorney in a Retirement Account you should be aware that the agent is not Authorised under
this document to make or change beneficiary designations on your account
ii Power of Attorney is granted on behalf of an entity to g trusU, please provide the dent names) and your name as representative of that
dent
g . 'as trustee':
IMPORTANT NOTICE FOR PACE/STRATEGIC ADVISOR ACCOUNTS: Ongoing advice from the LIIIS financial Advisor n a principal
component or the services dents pay far in these programs As such. Clients may not designate a Power of Attorney for the purpose of
obtaining investment advice on a UM PACE/Strategic Advisor account this inClude. registered or unregistered investment *dyne's.
consu:tants, financial planners or similar parties
GhtSaine
Matv'4 e
Client FirSI,Ptarne
last Name
CleeCiret Name
Last N
"1,
Date
Signature
Date
t- 2 -vs-
Date
:IMPORTANT NOTICE FOR PACE/STRATERK ADVISOR ACCOUNTS: Deigning advice born the UOS financial Advises is a pnnopal
component of the services dents pay In in these programs As such. clients may not designate a PON*: of Attorney for the purpose of
jobtaining investment advice on a UBS PACE/Strategic Advisor account This includes registered or unregistered investment advisors.
;consultants, financial planners or similar parties By signing below. I confirm that I am not providing investment advice or consulting 'ewes to
the dent gr aptin9 me a9ency on this account
Daniel
Agent First Name
ACcf•AZ (Rev. 12/141
Y-eSnee
last Name
Sign. mo
O2014 UBS financial Services Inc All rights reserved Member IP(
Par.e
CONFIDENTIAL
UBSTERRAMAR00000781
EFTA00236473