EFTA Document EFTA01580351

l9965000-ANCIS-Wdr °sego uethondr Aq paisanba8 fuewieau iettuappoo ZX3ONI IX3ONI DSO L0991£L I 1 010 ti to I ;68d 00 £5 Ol UNA l/£0 laP9Mergan Funds Transfer Request Moue Type Instniceon$ USD Transfer Information Effective Date: 03/10/13 Please enter current or fume date only Select Appropiate Payment Type and Fields will be Displayed O JPMC Transfer Principal: O ACH 0 Check O Domestic Wire Income: O International Wire $3,977.11 CrIgif.afor Information Debit Account #: Debit Account Title: Jeffrey E Epstein Receiving Party Information Address 1: Receiving Bank ABA: Receiving Bank Name: Beneficiary Account #: Wachovia Bank Address 2: Beneficiary Name: American Export Company City: State: Zip Code: Pay i hrotAgthilatcrrneatary Party (If Rcou.reel Account Type: O DOA (US) O Swift O Other Intermidiary Bank Account/Code: Intermediary Bank Name: Other Payment Details (Reference/Advice Description/Addenda) Inv # R1302121 Authoriz By 03/10/13 Date EFTA01580351