Aug 11 2014 11AOAM HP Fax

Aug 11 2014 11AOAM HP Fax Page 1 relt Bankwell Fax To: Fax: Phone: off From: Pages: Date: ( AMALI-OrCits/0 (INCLUDING COVER) O H M / Re: R'S kas2“Al l CC: Urgent G For Review O Please Comment O Please Reply O Please Recycle • Comments: The infomution contained in this facsimile message is intended only for the personal and confidential use of the designated recipient rained above. This message is privileged and confidential. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recipient, you are hereby notified that you have received this document in error and any review, dissemination, distribution, or copying of this message is strictly prohibited. If you have received this communication in error, please notify me immediately by telephone at (203)6524322 and retain the original message to ire by mail Thank yo 208 Elm Street, New Canaan, Cr 06940 Phone (203) 972-3830 Fax (203)968.7473 EFTA00283612 Aug 11 2014 11:00AM HP Fax NEW ACCOUNT INFORMATION * Banicvveit . DATE 08/07/2014 Check If applicable: n Temporary 0 Replacement Financial Institution Name And Address Ban Kve it ACCOUNT INFORMATION AMOUNT OF DiPCSIT 1 25,000.00 PLAN if Tint OF ACCOUNT REOHAWK PARTNERS LLC DANIEL M GROFF LESLEY K GROFF OWNERSEIP TYPE ac - T PRODUCT NAME Bankwell Business Checking won* runton a tam= InolFINI TY •c.. amid* enly when nrket 14.Z. Cprad IIII Lan ACCOUPC fort16'.,* ACCOUtr Torcasio BUSINESS ENTITY INFORMATION trallOSS BUS NESS NAME AND ADDRESS ENTITY REOHAWK PARTNERS LLC LAST RUNG DATE NATURE PR ASSUMED NAME 1F DMA RESOLUTION E-MAL CONTACT NAME FACSIMILE CONTACT TITRE LIMITED CONTACT PHONE BUSINESS OTNER • FLSIO STATE COCLWEN I FUND DATE EXPIRATION ESTABLISHED OF ()AIWA MARY LOCATION DATE ADORE% AUTHORIZATION ON Fitt 0 YES • IA L MILEY COMPANY TAX CIASSIRCATION: ENGAGES IN IN-ERFET GAMBLE/3 • 0 ll Pm 4 44cIal YOU mull 4414•44IIAM o4 **140414Y M **Ele In Mehl Gernetne. TAXPAYER IDENTIFICATION NUMBER CERTIFICATION Exempt payee code, if any: Under penalties of perjury, I certify that: Exemption from FATCA reporting code, if any: 1. The number shown on this form Is my correct taxpayer Identification number (or I am waning for a number to be Issued to me), and 2.1 am not subject to backup withholding because: its) I am exempt from backup withholding, or ID) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a faille to report all interest or dividends. or (c) the IRS has notified me that I em no longer subject to backup withholding (Notice: If you are subject to backup withholding, cross out this tine), and 3. 1 an a U.S. citizen or other U.S. person Iderined In the Wil Instructions), and 4. The FATCA codels) entered on this form (if any) Indicating that I am exempt from FATCA reporting is correct. 08/072014 Taxpayer Idantificartion Number: 47-1607018 SIGNATURE DANIEL M GROFF DATE ADDITIONAL TERMS Account Alternate Address: IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT. To help the government fight the funding of terrorism and money laundering activities, Federal law requires all linencial Institutions to obtain, verify, and record information that Identifies each person who opens an account. What this means for you: When you open en account, we will ask for your name, address, date of birth, and other information that will allow us to Identify you. We may also ask to see your driver's license tr. other Identifying documents. ACKNOWLEDGMENT. By spning this document, the undersigned acknowledge that they have opened the type of account designated above, and have received, understand and agree to be bound by the terms of the Account Agreement for that account type. The undersigned certify that all information provided to the institution is true and accurate. If this is a consumer account, the undersigned acknowledge receipt of an Account Disclosure, end a copy of this institution's Privacy Policy. The undersigned also acknowledge receipt whore applicable, of this Institution's Funds Availablity Policy and/or Electronic Fund Transfer Agreement. If this account is opened in the name of the bareness entity, all signers are acting on behalf of the business entity. All signers authorize this institution to make inquiries from any consumer reporting agency, including a chock protection service, in correction with this account NUMBER OF =NATURES Riaumm: 3 FACSIMILE ALLOWED El Authorized SON One litITE Auth Signer rated Spier Oely Tale: Auth Signer I ' 08/07/2014 08107/2014 DANIEL M GROFF Cror LESLEY K GROFF one • AuStrbelEknitOlk TAW 0 Aviteleed Sire ONE The: X X Dete Come =seamen hilt MO ITC II MiSAII•I NMI% Pie I N 2 ••••••••-•.L.----.—..— EFTA00283613