Case File
efta-01376574DOJ Data Set 10OtherEFTA01376574
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01376574
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
SELECT AND INITIAL THE APPLICABLE BOX FOR LIMITED OR FULL TRADING AUTHORIZATION
LIMITED TRADING AUTHORIZATION
(initials)
DBSI is authorized to follow the instructions of Agent(s) in every respect concerning the Account(s), and
Agents) is/are authorized to act for the Undersigned and on the Undersigned's behalf to buy, sell or enter into
trades of stocks, bonds, option contracts, or any other securities, or contracts relating to same on margin or
otherwise, as well as with respect to all other things necessary or incidental to the furtherance or conduct of
such purchases, sales or other trading activity.
Note: Limited Authorization does not permit Agent(s) to withdraw or transfer assets from the Account(s).
—OR—
FULL AUTHORIZATION TO TRADE AND MOVE ASSETS
(initials)
DBSI is authorized to follow the instructions of Agent(s) in every respect concerning the Accoungs), and
to make deliveries or transfers of assets (including cash), from the Account(s) and payment of moneys
as directed by Agentisl, without restriction (including to the Agent(s), himself, herself or themselves except
in connection with IRAs).
Note: This Full Authorization grants Agent(s) unrestricted authority to trade in the Account(s) and to withdraw
or transfer assets from the Account(s).
For IRAs, Agent is authorized to elect whether to make tax withholding elections in connection with distributions.
In all matters and things mentioned above, as well as in all other things necessary or incidental to the furtherance or
conduct of the Account(s), Agent(s) may act in the same manner and with the same force and effect as the Undersigned
might or could do.
This Authorization/Power of Attorney shall remain in full force and effect until DBSI receives actual written notice signed by
the Undersigned of its revocation to be delivered to the Undersigned's DBSI Client Advisor or his or her branch manager.
However, the limited power of attorney granted hereunder is not a durable power of attorney and will cease to be effective
upon actual receipt by DBSI of written notice of the occurrence of either of the following events: (a) the Undersigned is
judicially declared to be incompetent, or (b) the death of the Undersigned. Notwithstanding the foregoing, the Undersigned
acknowledges that DBSI shall be entitled to continue to rely upon this Authorization/Power of Attorney until such time as
DBSI receives such actual written notice.
The Undersigned understands and agrees that DBSI has the right to require additional verification and documentation from
the Undersigned or the Undersigned's Agent(s) in certain transactions that DBSI, in its sole discretion, deems necessary.
In addition, DBSI has the right to request that either a new Authorization/Power of Attorney be executed or that the Agent(s)
verify in writing the validity of the current Authorization/Power of Attorney.
Agent's Name
Agent's Name
Address
Address
TIN of Agent
TIN of Agent
Relationship to Principal
Relationship to Principal
THIS DOCUMENT DOES NOT REVOKE ANY OTHER POWERS OF ATTORNEY THAT
THE UNDERSIGNED HAS PREVIOUSLY EXECUTED, UNLESS THE UNDERSIGNED
HAS SPECIFIED OTHERWISE ON THE LINES BELOW.
WM167648-LIS 014707.031616
Page 3 of 7
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0072851
CONFIDENTIAL
SDNY_GM_00219035
EFTA01376574
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