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Deutsche Bank
Private Wealth Management
Authorization for Asset Movement
For Non-Retirement Accounts
the undersigned hereby euthorises end directs Deutsche Benk Aiex. Brown
['Deutsche Bsnk Alex. Brown' or 'DBAB') to Foflow the bekrw esset movement
instructions.
II you wish to request multiple wires, checks, (oumels or Free deliveries,
plesse use the long form.
DBAB Account Nemo; JeffTBV E Epotaln
Acooum f 35266976
Joumel
K Joumel Funds in the emount of $
Q Joumel Holdings:
Oty/Symbol/Securily;
aty/Symbol/Socurity.
Z1 Journal All Holdings
To DBAB Account#:
Account Name:
VW re
Q Wire federel funds In the amount of S 757,62
To Bsnk Name: Bank Of Amwilca
City / Slate
-
ABA#:
Further credit to Intermediary Rnancial Institution (Optional)
Account»:
Name:
021QQq??2
Utknsto BemrlkriBy brinmstiaii:
Renitawvhhme: YuIIh Slllnskava
Account#:
AddlionalhstiicloK 6X0 relmb,
4630 5666 6989
FteeDeMaa
K Please deliver the securities indicated below to-
DTCC#:
Name of Receiving Firm:
Account Name:
Check
Q Issue a check in the amount oft
Reopnnl'sNsma:
HedpoiTsMakigAildiess:
payefalela;
at Receiving Rrm
Account Number:
Qty/SymboiiSecuiily:
EFTA01402328
Qty/Symbol/Sscuiily;
lii
StBsftvA
o The undersigned hereby requests that this euihorization act es a standing
authoriation. The undersigned understands and agrees that this nulhorualion
will
remain In effect until Deutsche Bank Alex. Brown requests a new
author'uation. The undersigned authorizes Dauteehe Bank Alex. Brown to issue
the wire.
check or journal on the ,
o The undersigned further sulhorizes Deutsche Bank Alex. Brown to aocapt
verbal Instructions from the underslgnad to wire funds, issue checks or
journal
funds lofftom the ebove listed eocounts. The undeisigned will provide verbal
instructions as to the dale and the amount of the wire, check or journal. If
the
undersigned rleckkss to vary either the date or the amount of Ibe wire,
check or journal, the unrleisignBd hereby authorizes Deutsche Bank Alex.
Blown to
accept the verbal insiruciicns from the unrieisigned regarding the change or
changes. Tha underslgnad further understands and agiees to iximply with the
procedures of Deutsche Bank Alex, Brown to verify the auihoiizalion and
accuracy of verbal inslmdions.
day of
for e term of
The undersigned hereby acknowledges that (i) the informeiion oonuined in
this form Is complete and accuteta to the best knowledge of the undsrsignad;
and (iij the
undersigned is responsible for the method of transmission of any Inalnioions
issued pursuant to this eulhoriisUon. H the undersigned elects to transmit
any such
instructions via lax pncluding desktop fax), via email or as an image
attechmenl to email {e.g.. as a PDF. T)F or other image of such instmmions),
the under^ned
understands end agrees that the underslgnad beers the risk of loss arising
from such method of tisnamlesiofl in the svenl of irensmission errors,
misunderstandings.
Impersonations, transmission by unaulhorfzed persons, forgery or intercepts.
For mists or other entities, the undersigned luither acknowledges (hat the
undersigned is
auihonzed to issue the above asset movemem Instructions under the terms of
the governing documents end airy appticabte lawe. The undersigned hereby
leleasas and
holds harmless Deutsche Bank Alex. Blown from and against loss from any
action, claim or demand of any person ss a result of Deutsche Bank Alex.
Brawn's receipt of
or compfience with this authorization and/or any instructions that may be
given to Deutsche Benk Alex. Brown pursuant to this auihorizelion finduding
any standing
authrxizationj.
EFTA01402329
The undersigned undersisnds that Deutsche Bank Alex. Brown may, but is not
required to, aeek verincalJon of the underaigned's instructions by cell beck
and that
Deutsche Bank Alex. Brawn may In its sole diseralion refuse to execute such
instructions (including standing instnjctions) gn<<n pursuant to this
euihorization, without
Incurring sny liability, if Deutsche Bank Alex. Brown hae reason to bekeve
such instructions (or standing msimctions) have not been provided by the
undersigned. The
undersigned lurthar understands thaLPeutsche BenluAleiftBrown reteins the
right to refuse to execute eny instructions to transfer funds or securities
to any e000umfsj
purs^i to this authonzBiion witb/ul Vhfanfis^dCijons/Jearing original
signaiurels) of the undeisigned.
Darren K Indyke
I
11/05/15
Print Name
Pnni Name
Signaiuis
10-PWM-0177S (12/I01
EFTA01402330