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Deutsche Bank
Private Wealth Management
Authorization for Asset Movement
For Non-Retirement Accounts
The undeisgned hereby authorizes and directs Deutsche Bank Alex, Brown
("Deutscha Bank Atex- Brown' or "DBAB") to lollow the below asset movemenl
msiructions
II you wish to request multiple wires, checks, journals or Iree delweries.
please use the long lorm.
DBAB Account Name; Jaffroy E gpstftln
Account
Journal
Q Journel Funds in the amount of $
K Journal Holdings:
Qty/Symbol/Secunty
Oty/Symbol/Securily:
Q Journal All Holdings
To DBAB Account #:
Wire
[Z1 Wire federal lunds in the amount of S 210
To Bank Name: JP Morgan
City / State:
ABA«
Further ciedh to Inteimadlary Hnancial Inelllution (Optional)
Account #:
Name.
2
UHknatB Benefciaiv Infamation:
Beneiiciaiv Name:
Account Name:
Account#:
Q Please deliver the secunties indicated below to:
Adckonal InstnCDOns:
DTCC#:
Name of Receivino Finn:
OiaJc
Q Issue a check m the amount of
Reapient's Name:
Radfient's Mailng Addrats:
Account Name;
payable to:
Account Number:
at Receiving Firm
EFTA01402722
Oty/SymboiySecunly;
Qty/Symboi/Sacurily:
Startling Authorizalia)
Q The undersigned hereby requests that this authorization act as a standing
authorization. The undersigned understands and agrees that this
authorization will
remain in effect until Deutsche Bank Alex. Brown requests a new
authorization The undersigned authorizes Deutsche Bank Alex. Brown to issue
the wire,
check or Journal on the
. ^
Q The undersigned further authorizes Deutsche Bank Alex. Brown to accept
verbal instructions from the undersigned to wire funds, issue checks or
journal
funds to/from the above listed accounts. The undersigned will provide verbal
instructions as to the dale and the amount ol the wire, check or lournal. If
the
undersigned decides to vary either the dale or the amount ol the wire, check
or (ournal, the undersigned hereby authonzes Deutsche Bank Alex. Brown to
accept the verbal instructions from the undersigned regarding the change or
changes. The undersigned further understands and agrees to comply with the
procedures of Deutsche Bank Alex Brown to verify the authorization and
accuracy ol verbal instnjctions.
day of
for a term of
The undersigned hereby acknowledges that (i) the infomiation contained in
this form is complete end accurate to the best knowledge of the undersigned;
and fii) the
undersigned is responsible for the method of transmission ol any
instructions issued pursuant to this authorization. If the undersigned
elects to transmit any such
insiiuctions via fax (including desktop fax), via email or as an image
attachment to email (e.g. as a PDF, TIF or other image o( such
inslroclions), the undersigned
understands and agrees that the undersigned bears the risk of loss arising
Irom such method of transmisson in the event ol transmission errors,
misunderstandings.
impersonations, transmission by unauthorized persons, forgery or intercepts.
For trusts or other emilies, the undersigned further acknowfedges that the
undersigned is
authorized to issue the above asset movement instructions under the terms of
the governing documents and any applicable lows. The undersigned hereby
releases and
holds harmless Deutsche Bank Alex. Brown from and against loss from any
action, claim or demand of any person as a result of Deutsche Bank Alex.
Brown's receipt of
or compliance with this authonzalion and/or any msiructions that may be
given to Deutsche Bank Alex Brown pursuant to this authonzalion (including
any standing
authonzation).
The undersigned understands that Deutsche Bank Alex, Brown may, but is not
required to, seek venficaiion of the undersigned's instructions by call back
EFTA01402723
and that
Deutsche Bank Alex Brown may in its sole discretion refuse to execute such
instructions (including standing instructions) given pursuant to this
authonzalion, without
incurring any liability, if Deutsche Bank Alex. Brown has reason to believe
such instructions for standing instrucUons) have not been provided by the
undersigned. The
undersigned further understands that Deutsche Bank Alex. Brown retains the
nghl to refuse to execute any instructions to transfer funds or secunUes to
any accounifs)
pursuant to this authorization without wntten instructions bearing original
signalure(s) of the undersigned.
Darren K Indyke
11-03-15
A
V
e
£lp<*i.>i»
Print Name
Date
50iiMin
Print Name
Date
III I III mil I III III
LOA
tO-PWM-0177S 112/10)
EFTA01402724