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efta-efta01434981DOJ Data Set 10CorrespondenceEFTA Document EFTA01434981
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EFTA DisclosureText 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:
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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