EFTA Document EFTA01590165

From: bellaklein [mailto: To: PB-Service1318 Cc: Richard Kahn Subject: ]EE WT to SP Please confirm, Thank you, Bella Begin forwarded message: From: Date: November 27 2012 10:34:26 AM EST To: Subject: Messa e from KMBT C253 Reply-To: EFTA01590165 ID: 036211277459219 DATE: 11/27/2012 16:46:00 Page 1 of 2 DID: 8887316607 CSID: INDEX1: INDEX2: Funds Transfer Request (Please Type Intliructrons) J.P.Morgan USD Tran6-idr ihforration .Effective Date: 11/27/12 Pease enter current or future date only Seleci Approplate Payment Type and Fields will be Displayed JPMC Transfer ACH 0 Check 0 Domestic Wire International Wire Principal: $682.81 Income: Originator In'orniation Debit Account #: Debit Account Title:. Jeffrey. E. Epetnin Receiving Party Inforrntion Address 1: Receiving Bank ABA: Receiving Rank. Name: JPMorgan Chase Address 2: Beneficiary Account 1/: Beneficiary Name: City: State: Zip Code: Pay Through/lntennediar Party (if Required) Account Type: DDA (US) 0 Swift 0 Other Intermidiary Bank Account/Code: Intermediary 86,1I1C Name: Payment Details (Reference/ Advice Description/Addenda) Reimbursement for Luggage bad EFTA01590166 11/27/12 Authorized y Date ID: 036211277459219 DATE: 11/27/2012 16:46:00 Page 2 of 2 DID: 8887316607 CSID: INDEX1: INDEX2: EFTA01590167