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efta-efta00123692DOJ Data Set 9Other

2012•Nov-15 0315 PM RANK OF AMERICA

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 Dielemm

Date
Unknown
Source
DOJ Data Set 9
Reference
EFTA 00123692
Pages
2
Persons
0
Integrity

Summary

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 Dielemm

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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
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 TEXAS, VIRGINIA & NORTH CAROLINA ONLY; IOW OWNERSHIP TYPE SELECTION: (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

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SWIFT/BICCAROLINA
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SWIFT/BICSELECTED
SWIFT/BICVIRGINIA

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