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efta-efta01434981DOJ Data Set 10Correspondence

EFTA Document EFTA01434981

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DOJ Data Set 10
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efta-efta01434981
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
EFTA01434981 Deutsche Bank Wealth Managennent Authorization for Non-USD Wires -or Non-Retirement Accounts The undersigned hereby authorizes and directs Deutsche Bank Securities Inc. (DBS!) to follow the below asset movement instructions. DBSI Account Name Account Number SOUTHERN FINANCIAL LLC N4GXXX804 3. Ultimate Beneficiary Information (required) Deutsche Bank AG, London 1. Non-USD Wire PLN/3,982,916.26 Beneficiary Name: Currency/Amount: DEUTGB2L Bank Information: Second Beneficiary Name: DEUTPLPX SWIFT ID/BIC: PL89188000090000001370003035 IBAN/Account#: Deuteche Bank Polska SA To Bank Name: Ref: SOFL Additional Instructions: Warszawa City: 2. Second Bank Information (if applicable) SWIFT ID/BIC: To Bank Name: City: Country: Account #: Further credit to Intermediary RnarKil Institution (if appPcable) Account#: Name: Standing Authorization: Checking both boxes allows you to verbally vary instructions set forth in box A. 0 A 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 DBSI requests a new authorization or DBSI receives notice of the revocation of these instructions. The undersigned authorizes DBSI to issue the wire EFTA01434982 day of until otherwise instructed. This authorization will expire after on the 15 months of non-use. 0 B The undersigned further authorizes DBSI to accept verbal or electronic instructions from the undersigned to wire funds to/from the above listed account(s). The undersigned will provide verbal or electronic instructions as to the date and the amount of the wire. PLEASE NOTE: The undersigned understands and agrees to comply with the procedures of DBSI to verify the authorization and accuracy of verbal or electronic instructions. 0 m 0 Page 1 of 2 VI179313 011507.120117 The undersigned hereby acknowledges that (i) the information contained in this form is complete and accurate to the best knowledge of the undersigned; and (ii) the undersigned is responsible for the method of transmission of any instructions issued pursuant to this authorization. If the undersigned elects to transmit any such instructions via fax (including desktop fax), via email or as an image attachment to email (e.g., as a PDF, TIF or other image of such instructions), the undersigned understands and agrees that the undersigned bears the risk of loss arising from such method of transmission in the event of transmission errors, misunderstandings, impersonations, transmission by unauthorized persons, forgery or intercepts. The undersigned hereby releases and holds harmless DBSI from and against loss from any action, claim or demand of any person as a result of DBSI's receipt of or compliance with this authorization and/or any instructions that may be given to DBSI pursuant to this authorization (including any standing authorization). For trusts or other entities or agents acting on behalf of Client, the undersigned acknowledges that the undersigned is authorized on behalf of Client to enter into this authorization and issue the instructions under the terms of the governing documents and any applicable laws. The undersigned understands that DBSI may, but is not required to, seek verification of the undersigned's instructions by call back and that DBSI may in its sole discretion refuse to execute such instructions (including standing instructions) given pursuant to this authorization, without incurring any liability, if DBSI has reason to believe such instructions (or standing instructions) have not been^rpvidecfbyTh&ijndersigned. The undersigned understands that DBSI retains the right to refuse to execute any i^structioo8^:5^nsfer funds or securities to any account(s) pursuant to this EFTA01434983 authorization without written instructions bearing originarsignature(s)of the undereigned. Further, the undersigned acknowledges that DBSI shall be entitled to rely on the authorization until actual receiraby DBSI of notice of: (i) Client's or the undersigned's revocation of the instructions or(ii) the death otN^al incapacity of Cjient (if Client is a natural person) or the undersigned. Print Name Date Signature Print Name Date Signature 02017 Deutsche Bank AG. All rights reserved. WM179313 011507.120117 EFTA01434984

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