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2012•Nov-15 0315 PM RANK OF AMERICA
1/2
Bank of America 'e
Personal SIgnature Card
It lNi2 (IF AMERICA, NA frI1G "BANK,
with Subatitute Form W-9
Aeeount Number
Accouut Type:
ET ULM
[3 SAV
El CD
AccouUt
Bank Number.
_
Individuel Owner
TX, VA, di NC: IF JOINT OWNERS, THE JOINT OWNER SURVIVORSFHP MUST BE SELECTED ON PAGE 2.
ALL OTHER STATE!: IF JOINT «NERE, SELECT FROM THE APPROPRIATE SURFIVORSHIP BELOW.
K
Joint with Right of Survivoribip
El Tentat! by Entiretlet (Form ofJolat with Right otSuravershIp for spenat co-ovraen enly. Nate Defelts
to Jolm with Right of Survivonklp If state law do,, elo: molok* Tamts by Ca timitt for bank inmal)
nios irdesistmuing fiCOCIIChlf klit: 0 !kabla on Death (POD) / In Trust For (ME) / Totten Trust (Retar to Beneficiary Addendum for dotalls)
Ii algring Mon, IM e neka owlcdge and mate dat this cement It and vill be govemtd by the torrro and condttions 101 forth in du> accent opening decumenta,
inCintIng die Deposit Avec:mu am Dielemma and the Personal Schadc le of Fes. 1/we acksowiedge the reeelpt of those doccmentt Uwe unditnta ad sad agne
nut tu Mink may dunig Mae timme:ng at any time by niding new tenns, or doiceing or amen:lins exitting terms. The Depetit Ag:cement inotudcz a provision for
vin uul nure:
rcibrenge :n n lodkul rercrce. A ;sånt accoent with right of turviveraktp la tbc propony of each co-owne and payable to abber comener or to the
.ute et ent brhownOtt el int cn.nwncr
ly chtekIno da bot marked "ATk1/Deble Card Requeatedr Uwe hemby requeet sa Automat Teller Mathieu Card and/or a Dit Cud. By algolog West Uwe
niomen( en the immance af an ATM cord anar Debit Care to the other aocount hold«, indieatod below. By gigning blow, r/WO lek now ledge mad egner thtt the
antennfri wall urwc as ventleation for any transacuon in etioneCtIOn with this At count, and aa the cortifleadon (tet feel kron of IM tennets idcmirntim number
i Hoa
Subailleir Fornt W.9
( en i Ikanon Dada pengars of pajury. I cent fy thet: C I I The number showa on this fem Is the COMX: ta.maye identlfication number(or l am waldr.g for a nach.:
he he witucd MIMI: and (2) I vii not itiNeet to brokap wnhholdMg bantun: (A) I am cent from backup withholdIng, or (B)1 have rot been molnen by the Intrial
Reken& Senice (IRSIthat i am subject lo backup withboking as a result of a failure to report etl Internt or divetendt. or (C) tho IRS 'ms noidled me the i am no
hinner ichmet la back up wIdaolding, nnd (3)1 sin a US ettao or other Ut porton (Deand In the W-9 instructbr4).
t kronvittne lustructlaus
You mat erors out kan 2 ab»: if you have been nollled by the IRS :hat you are etirrently subject to biokup withholding tonus* you have falled to non all intimt
and ,b,idendi on yxur tov ment Fm real asnia InIfleielkint. Item 2 dom rot apply. For montage nitrat pakt, acquisition or abandonment of acered propny,
,nnecl hunn ni duk coniribunnos to an :Matchat ra:romani enengen ent (IRA). and generally, payments nalrer titan haleren end dividende, yeu tt not required to
men da teniacation. Ian you mun provIde your ourniet TIN. (Platta retor to the IRS Mitmetions for Form Wii9).
[
The Internat Reven°, Service doge ni ramla your manet lo any provision of tble dOCutnent other !ban the certlIka dons
rrquired to avoid backup wIthholcling.
K
%
nn ronden t kilen State lir spri Itehity If you and all of the jolni ownon of this rerite: are foreign pennina check hena and complere end döp lh. applicabla
I mul:OW-8
lin Ila Sulan
Rot
Internt
On Ves/No
Fristed Name
Montera
Data
ATM/Debit Gerd
Remissa
Check If Y •
. Ar
0.
FA a
e
vev
noa 1.4205h4 084012
0 20:20 kolon rio , NÄ. All Riglas Reserved
Ii Inri III Ill IIIIIIQIIII I INI IM B Ill H
Page I of 2
EFTA00123692
2012-Nov-15 0315 PM BANK OF AMERICA
2:4
CAROLINA ONLY;
(YAW PROBATE CODEll 439. VACA 06.2.418,NCOS O3-146.1)
During the lifetime of the (comers of the account, the Bank may pay the money in the account to, or on the order cf. any person invitee tw the
eceount,
Joint Accounts um be with or without survivorship.
With survivorship means upon the death of one Juno owner, the money remelting in Ow annum will belong io the eurvivinp;
owner(s). and will not be inherited by the heirs of the deceased joint owner or controlled by the deceased toner's will.
Without survivorship meant if one of the owners dies, the deceased owner's ownership interest in the account passes as pan of the
owne's estate under the owner's will or by intestacy If there is no will.
Joint Account Survivorship SNection (Select One of the following options. all owners must sign and date)
K
Joint Aceoust • With Survivorship/Tenants by Entireties (with Survivorship for Spouses)
OR
K
Joint Accouat — Without Survivorship
Signer Incormatioa
Customer I
Account Owner's Signature
Dstc
Castomer 2
Account Owner's Signature
Dew
Customer 3
Account Ownor's Signature
Data
customer 4
Amine Owner's Signers
Dam
Customer 5
Account Owner's Sigruture
Duo
Coate
Name
US Mire liens WIPholu
Review Information
Approved Existing
a
Cuatomer 2
Name
Review information
Cy:tomer 3
Lyme
Review Worms:ton
Cattomer 4
Name
Review information
Customer
Nimes
RIM iM• Information
Dank WormetIon
Date
Banking Center Name
itoeletes Name
Auociatela Phone Number
II/1420[2
ALLPTON AVENUE'
Ali-Sherif Robinson
NNY
CO-le-929W CS-2012
111111111111T
'1111111
III lilt IIIII I I'll I I I III I III. I IIIIIIIII
EFTA00123693