Text extracted via OCR from the original document. May contain errors from the scanning process.
SUBS
UBS Financial Services Inc.
Account Number
PWM Off ice
Pr Nate Wealth Advise,
Power of Attorney (PWM)
(Not for use when naming a professional Investment Advisor)
ca
Account Name
' initial here t
this authorization apply to all accounts at UBS Financial Services Inc in the same name, wheelies currently open or opened in
future
This will confirm the authority of Daniel Kerner
.1
(Agent IVJMC)
to pedorm each of the actions initialed below and to take any and all actions necessary for or incidental to carrying out such authorizations
including the execution of documents or forms or other authorizations
is
Note When rued in this document. the words 'I'. or 'nor' or *my' refer to each of the chenest/prinopalls). individuals) or eritil(es), that
kjait
executes this Power of Attorney
1)85 MCI
client mint initial in the box next to sad. agent, granted. PLEASE SEE IMPORTANT DISCLOSURES REGARDING TRADING
• AUTHORIZATION FOR
AND STRATEGK ADVISOR ACCOUNTS ON PAGES 2 AND 3
.
.
. .
.
' . •
Trading Authorization
i initial here to authorize my Agent to enter ciders with you to purchase and it securities and similar property (including °plan
iransadions), in accordance with the nolificationS. eligibility and general terms and conditions for my account(s), as brokers or
dealers acting for my own aCcount(s), or as brokers for some other person
WNW) Account Asanceization
r e.7
I initial here to authorize my Agent to enroll my account in any enveatmenl advisory program offered by URS, to elide the
Investment AdirrSOry Relationship Agreement or applicable forms, and specifically to hire
terminate discretionary
non.
discretionary investment managers i understand that the Advisory Relationship Agreement. whether executed by me or my Agent.
will apply to all UBS advisory program accounts that I may open in the future
Disbursesnant Authorizations
j I abet here to authorize my Agent to instruct ties to transfer money or securities to accounts held an my name or for my benefit.
and to make tax withholding Sections on my behalf in connection with any transfer authorized under this Power of Attorney Such
transfers may be effected by methods which include but are not limited to puma' entries. wire transfer, electronic funds transfer of
Checks
Tax Documents AuthoriZatiots
I initial here to authorize my Agent to make, execute and present tax forms, including without limitation all US Internal Revenue
Service Forms W.8 and W'9. as applicable, and any related documents
I. Account Information Authorization
I initial here to authorize my Aral
to receive a duplicate copy of all COnfirM4hOns, statements and other COnniunvations
Arab
II I have designated muitipki agents to act on my account(s), I direct that each agent is authorized to act independently of any other agent lf
UBS Essential Services Inc determines. in its sole discretion. that it is receiving conflicting instructions from agents that I have designated, I
authorize 1185 Financial Services Inc , in its discretion to stop taking instructions from any of my agents until the conflict is resolved tither al my
direction or by my designated agents
Sign th4 SWIM if you intend Mal mullipie agents mug sayointly. Untss signed below you atsMOnze each agent to act separately
d I nave designated more than one agent for my accounts, I direct that UBS Financial Senores Inc act only upon the loin: instructions of an
dewmated agents
0 Client Lest Name
last Name
%Puttee
A(•Ml1Rev 12/14)
02014 U85 Financial Services Inc All rights eservea Member
Date
Page 1 3
CONFIDENTIAL
UBSTERRAMAR00000922
EFTA00236595
UBS
Agreemert
By signing below. I agree to indemnify and hold harmless UBS and ns affiliates and all of thee employees and agents from and against any and
al claims that may arise by reason of UBS hang foiled on the provisions of this instilment t xanovAeoge and agree that my agent is
authorized to make any trade for which my account is *ibis or approved, ncluding 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 aft transaction, trades or dealings, whether written or verbal.
effected in and for my accounts) by my agent in connxbon with the authority granted in this nuturnent, including. but not limited to. the
execution of documents, forms or agreements or any authorizations If I have instrixted that this Power of Attorney be accepted in a Trust or
Business Service Account. I expressly acknotiedge and agree that, by signors; Wow, I delegate the foregoing authority I have as Trustee or
Officer, Member, Manager. Panner or other representative duly authorized, and sign this Power of Attorney CO such representative capacity or
capacities as applicable for the accounts to which this authorization applies
This Power of Attorney will be sutsect to. controlled by and interpreted in accordance with the laws of the State of New York, without gmng
effect to any principles of choice of law or conflict of laws Motwithmandng any ',cannon to the contrary contained In any application for any
account at UBS or in any other document)
thiS is entitled to rely on this Power of Attorney until written notice of its revocation is delivered to the branch office where the account is
maintained and receipt is acknowledged by OBS (wollnamt in discretionary UBS Investment Advisory programs wit for those
accounts, immediately and effectively revolts any trading authorization granted herein. In addition. some of the services you have
..elected may be subiect to limitations on their availability as requited t7f
ta"a or our Nacres, .cad under those cccunntances.
senates may be terminated or declined in UBS' sole discretion For example. UBS Financial Advisors cannot be appointed Power of
Attorney to any retirement &Mune.
this is an important legal document. Before executing this document, you should know those important facts
•
This document may provide the person you designate as your agentrattorney.m.fact with broad powers, including power to
manage, sell dispose of the assets in your account or borrow money using your property as 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 authorized under
this document to make or change beneficiary designations on your account
If Power of Attorney is granted on behalf of an entity (e g Ouse. please provide the client turners) and your name as representative of that
(bent tag , 'as trustee')
TPAPORTANT NOTICE FOR PACE/STRATEGIC Aronson ACCOUNT* Ongoing advice horn the ll15 Financial Advisor is a principal
rillent
of the services clients pay for in these programs. As such, clients may not designate a Power of Attointy for the PurPOSe of
htaning investment advice on a UBS PACE/Strategic Advisor account. This includes registered or unregistered investment admen
financial planners or alai parties
Ghislaine
Ma :w
___
4•1•1S-
Ckent First Name
last Name
sit- atter
Date
Ckent First Name
Last Name
esence of 'cannot be the Agent.
/4144/ .r5A
A-ige-Ea /4
Wnness first Name
tan Name
. .
must sign and date hi the pretense Warren who mot also sign and date this form
Date
Date
IRfORTANT NONCE FOR PACE/STRATEGIC ADVISOR ACCOUNTS: Ongoing advice horn the UBS Financial AcMscs is a pividpal
component of the services dents pay for in these programs As such, clients may not designate a Pont of Attorney for the purpose of
obtaining investment agate on a OBS PACE/Strategic Advisor account This includes registered or unregistered investment &Anon.
consultants, fins vial planless or similar parties By signing below, I contimi that I am not prodding Mniffnent advice or consulting services to
he client granting me agency on this account
0
Daniel
Kesner
Agent First Name
last Name
AC-M2 (Rev. 12/14)
I
(arairro
Dale
INVOIR1111
02014 UBS lmanual Services inc All ghts !ON elf Member SJPC
CONFIDENTIAL
UBSTERRAMAR00000923
EFTA00236596
UBS
ADDITIONAL INFORMATION (To Se Completed by Agent)
Basic kdonnatIon
Li Check here d agent is Ul35 financial Advisor °reregistered associated person al INS
Daniel
Kesner
Agent Fest Name
Mid* Name
Last Name
Country of Citineedlip.
USA
O
Other (speedy)
PasSport/Cedula
SSN
C/O Marks Paneth
_
Address lane 1
-
Country
Mine phone
Agent's Reiationshp. tt Any. to Principal
Agent's Account No With UBS Of Any)
Financial Information
investment Experience: How many years have you held investment accounts) 20
years
*hot Geo ritvotos yOur S000dfocige of investments) K !know very ktde about financial markets and market investments
i have a good understanding of financial markets and market investments
D
i am an experienced investor in financial markets and market investments
Personal Information
Date of gent
Is the Agent a acted with any secedes firm. excluding UBS and its affiliates, poker/theater subsidory of a financial institution, securities or
comrixoddies exchange, self aeguratory organizaton or the UR5 auditor ;currently Ernst
Young17 (NYSE Rule 407:
S No
— Yes 91 blank. Firm assumes No If yes specify affiliated temlorgangation
If you answer 'yes' to the NYSE Rule 407 question. approval must be obtained from the specified funvorganuation before the account can be
opened a trading authority becomes effective
is the Agent an employee or related to an employee of UBS AG, Is subsidiaries or affiliates re 9. UBS financial Services inc U85 Strung*. ILO,
No
Yes . specify Alf awletSubudiary
Employee first Name
Last Name
5SN
Employment Information
Occupation, Employer Name and Address are only requned if your employment status is erne/owe or . seti-emPloYed.
Status (select one;.
2) Employed ED Self •Emraoyed E l Student r
Retired K Self•Supported C
Volunteer 0
Unemployed 0
Work in the Home
Other
occupation
Business Phone(optional)
Marks Paneth
Other
imployer Name
Address Line I
City
AC-MZ (Rev 12/14)
State/Proinnce
Business lax (optonall
Industry (l .e . Construction Service. etc) (oplormal)
Address toe
United States of America
Zip/Postal Cone
(Oorttry
O2014 UBS ht14110.31Services Inc AN sights 'served Member UK
Page 3/3
CONFIDENTIAL
UBSTERRAMAR00000924
EFTA00236597