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efta-efta01480380DOJ Data Set 10Correspondence

EFTA Document EFTA01480380

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DOJ Data Set 10
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efta-efta01480380
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
POWER OF ATTORNEY INFORMATION DATE POWER OF ATTORNEY RECEIVED / I POWER OF ATTORNEY NAME POWER OF ATTORNEY SIGNATURE X ADDRESS (Street and Number) CITY STATE ZIP CODE BENEFICIARY INFORMATION r---- am ADDITIONAL ACCOUNT SIGNERS • (For Estate and Trust accounts, a needed) • Line out unused Signature boxes PRINT NAME TITLE SIGNATURE 7 X X ,, X VERIFICATION 2 --- Primary Applicant: ID-I: DL IDX. St. FL Exp: OI/01/2006 ID-2: PP IDI/: St Exp: 01/30/201 ChexSystems:Approved Code:950D SSN -ST:FL YR:2004 TU:Override CDE:8 FPH: Override Approval By: ,ir :700 1 Joint Applicant: ID-I: IDS: St Exp: ID-2: ID": St Eigx ChexSystems: Code: SSN-ST: YR: TU: CDE: FPH: NOTARY INFORMATION (For Worldwide Consumer Bank) STATE OF COUNT' OF SS.: before me personally came On the day of to me known. and known to me to be the individual described and he acknowledged to me that he executed ir2atn&WCexecuted the foregoing instrument me. THE INFORMATION AND (P40 y SIGNATURE(S) (POA AND ADOITIONAL SIGNERS) WERE VERIFIED BY: Not ituTR. No.: I Pot Nemo wawa 03.9415 (Stock Order*) Fen' Confidential Treatment Requested by JPMorgan Chase CONFIDENTIAL JPM-SDNY-00002526 SDNY_GM_00271724 EFTA01480380

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