Text extracted via OCR from the original document. May contain errors from the scanning process.
0049(0i
..ntrat:
For Natural/Individual Persons For Brokerage Accounts and/or retirement accounts with DB51
This Authorization/Power of Attorney constitutes a non-durable limited power of attorney, designed to
give a person or persons designated by you either (1) limited authority over your Account(s) or (2) full
authority over your Account(s) as set forth below.
CAUTION TO THE PRINCIPAL: Your Power of Attorney is an important document. As the "Principal," you
give the person whom you choose (your "agent") authority to spend your money and sell or dispose of your
property during your lifetime without telling you. You do not lose your authority to act even though you have
given your agent similar authority. When your agent exercises this authority, he or she must act according
to any instructions you have provided or, when there are no specific instructions, in your best interest
"Important Information for the Agent" at the end of this document describes your agent's responsibilities.
Your agent can act on your behalf only after signing the Power of Attorney before a notary public.
You can request information from your agent at any time. If you are revoking a prior Power of Attorney by
executing this Power of Attorney, you should provide written notice of the revocation to your prior agent(s)
and to the financial institutions where your accounts are located. You can revoke or terminate your Power
of Attorney at any time for any reason as long as you are of sound mind. If you are no longer of sound mind,
a court can remove an agent for anting improperly. Your agent cannot male health care deeisicms for you.
You may execute a "Health Care Proxy" to do this. The law governing Powers of Attorney is contained in the
New York General Obligations Law, Article 5, Title 15. This law is available at a law library, or online through
the New York State Senate or Assembly websites, Ivww.senate.state.ny.us or www.assembly.state.ny.us.
If there is anything in this document the you do not understand, you should consult with your lawyer.
AUTHORITY
The idersignql Principal (the "Undersigned" or "Principal") hereby appoints:
/N.) !pp./fit,- ,,-
I'
s ivcri
as the Undersigned's agant(s) and attomey(s)
in-fact (' gent(s)") to act INDIVIbUALLY with respect to any and all accounts, if applicable (see below) in the
Undersigned's name ("Account(s)"), held individually or jointly (provided that all joint account holders have
executed this form) with DBSI, as well as individual retirement accounts held for the benefit of the Undersigned
("IRAs"), with the authority to direct DB51 to buy, sell (including short sales) and otherwise transact in any
security, including but not limited to stocks, bonds, mutual fund shares, limited partnership interests, call and put
options (coveted and uncovered), en margin or otherwise, and any instrument, agreement or contract relating
to same, on margin or otherwise, or enter into futures, options on futures and forward contracts, interest rate,
currency, equity or commodity swap transactions, deposit accounts at financial institutions and direct or indirect
interests in securities, deposit instruments or contracts where all or part of the return is calculated by reference
to changes in, among other things, the value of securities, commodities, currencies, interest rates, property of
any description or indices, in each case in accordance with DBSI's terms and conditions for the Undersigned's
account, account type, and risk and in the Undersigned's names. or number(s) on O851's books. Agem(s) must
exercise the authority granted herein pursuant to the Undersigned's instructions, or otherwise for purposes
which the Agent(s) reasonably deems to be in the Undersigned's best interest. By giving this authority, the
Undersigned authorizes Agent(s) to make inquiries on the Accoum(s), including requesting information about
account transactions, balances and holdings.
4i
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CONFIDENTIAL
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DB-SDNY-0001636
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Principal agrees that DBSI shall not be obligated to proceed with instructions that are inconsistent with
the terms of any agreements governing the Account(s), or that would violate any applicable laws, rules or
regulations, or that would be otherwise limited by the accoum type or documentation on file.
AND TRANSACTION CONFIRMATIONS UPON THE AGENT(S)'S REQUEST. DBSI RETAINS THE RIGHT
THE MAILING ADDRESS ASSIGNED TO THE UNDERSIGNED'S ACCOUNT(S) OR ANY BENEFICIARY
DESIGNATIONS.
NOTE: If you want to authorize your Agent(s) to make gifts of your money or assets or other property held in
the Account(s) during your lifetime, without restriction, to any one or more persons, including the Agent(s)
himself, herself or themselves, you will need to execute a Statutory Major Gifts Rider. Giving such a power to
your Agent(s) grants your Agent(s) authority to take actions whidh could significantly reduce your property
or change how your property is distributed at death. DBSI shall not be responsible to monitor whether any
payments or transfers are gifts and/or require the execution of a Statutory Major Gifts Rider.
K LIMITED TRADING AUTHORIZATION. In all such purchases, sales or trades, DBSI is
-hi
authorized to follow the instructions of Agent(s) in every respect concerning the Account(s), arid Agents)
is/are authorized to act for the Undersigned and on the Undersigned's behalf in the same manner and
with the same force and effect as the Undersigned might or could do with respect to such purchases,
sales or trades as well es with respect to all other things necessary or incidental to the furtherance or
conduct of such purchases, sales or trades.
Note: This Limited Authorization does not permit Agent(s) to withdraw or transfer assets from the
i
count(s).
I /1"
E‘LL AUTHORIZATION TO TRADE AND MOVE ASSETS. DBSI is authorized to follow the
invsass
structions of Agent(s) in every respect concerning the Account(s), and to make deliveries or transfers
of assets (including cash), from the Account(s) and payment of moneys as directed by Agent(s), without
restrictionfirrelesdingttegforcerontK himself, herself or themselves except in connection with IRAs)
in accordance with DBSI's terms and conditions and account type. In all matters and things aforementioned,
as well as in ail other things necessary or incidental to the furtherance or conduct of the Account(s), Agends)
may act in the same manner and with the same force and effect as the Undersigned might or could do.
Note: This Full Authorization grants Agent(s) unrestricted authority to trade in the Account(s) and to
withdraw or transfer assets from the Accounts).
For IRAs, Agent is authorized to elect whether to make tax withholding elections in connection with
distributions.
This Authorization/Power of Attorney shall remain in full force and effect until DBSI receives actual written
notice signed by the Undersigned of its revocation to be delivered to the Undersigned's DBSI Client Advisor or
his or her branch manager. However, the limited power of attorney granted hereunder is nes a durable power
of attorney and will cease to be effective upon actual receipt by DBSI of written notice of the occurrence of
either of the following events: 0) the Undersigned is judicially declared to be incompetent, or (ii) the death of
the Undersigned. Notwithstanding the foregoing, the Undersigned acknowledges that DBSI shall be entitled
to continue to rely upon this Authorization/Power of Attorney until such time as DBSI receives such actual
written notice.
2
11-PWALONS101/12)
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SDNY_GM_00038813
CONFIDENTIAL
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-O001637
EFTA_00 I 49422
EFTA01283115
The Undersigned understands and agrees that DBSI has the right to require additional verification and
documentation from the Undersigned or the Undersigned's Agent(s) in certain transactions that DBSI, in its
sole discretion, deems necessary. In addition, DBSI has the right to request that either a new Authorization/
Power of Attorney be executed or that the Agent(s) verify in writing the validity of the current Authorization/
Power of Attorney.
Agent Name:
Address: 51 C
py
TIN of Agent:
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Relationship
AA
to Principal:
Agent Name:
Address:
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TIN of Agent.
Relationship
to Principal:
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LINES BELOW.
INDEMNIFICATION
The Undersigned acknowledges and agrees that the Undersigned is responsible for all acts of the Agent(s). The
Undersigned hereby agrees, individually and on behalf of his/her heirs, executors, legal representatives, and
assigns to indemnify and hold harmless DBSI and its parents, affiliates, subsidiaries, officers, employees, and
agents (collectively, "DB") from all claims that may arise in connection herewith, and to pay DB promptly, on
demand, any and all losses and liabilities arising therefrom or from any action taken or not taken by DB in reliance
hereon, including without limitation, any debit balance due with respect to the Account(s). The Undersigned
further hereby ratifies and confirms any and all transactions (including any payments or transfers) made by the
Undersigned's Agents) in connection with the Accoum(s) prior or subsequent to the execution of this document
and holds harmless D8 regarding same.
This Authorization/Power of Attorney shall inure to the benefit of DB and its sucoessors and assigns irrespective
of any change or changes at any time in the personnel thereof for any cause whatsoever.
The Undersigned understands and agrees that the DBSI may require joint account hoidens) to sign all requests
for withdrawals from an account jointly with the Agent(s).
3
PMA.09435 I01/12)
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CONFIDENTIAL
CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0001638
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The Undersigned by signing below confirms that he/she has read the contents of this Power of Attorney
and understands same, and has executed this Power of Attorney of his/her own free will and has received
advice about the effect of this Power of Attorney from his/her advisers as he/she has deemed necessary or
advisable.
In witness whereof, the Undersigned has executed this Ayttfiaon/Power of A °me .
Date:
/0473
Signature:
/
.--
.
Print Name:
4
RI
(the "Under./ ned") '
In witness whereof, the Undersigned has executed this Authorization/Power of Attorney.
Date:
Signature:
Print Name:
(the "Undersigned")
This section intentionally left blank.
4
11.PWM.0886(011121
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CONFIDENTIAL
CONFIDENTIAL — PURSUANT TO FED. R. GRIM. P. 6(e)
DB-SONY-0001639
EFTA_00 149424
EFTA01283117
ACKNOWLEDGEMENT OF PRINCIPAL'S SIGNATURE IN NEW YORK STATE
'41
ss.:
On
ociloinA
before me, /4,47 13€(6*--
personally
.11/27 ,
appeared 17
(-qc f. personally known to me Or proved to me on the basis of satisfactory
evidence to e the ind id ual s) whose name(s) is (are) subscribed to within the instrument and acknowledged
to me that he/she/they executed the same in his/herhheir capacity(ies), and that by hi hefftheir signature(s)
on the instrument, the individual(s), or the person upon beh
of whom the.in
ual(s) acted, executed
the instrument.
Notary Public
HARRY I. SELLER
Notary Pe:)tic. State of New York
No 01 a E4853924
ACKNOWLEDGEMENT OF PRINCIPAL'S SIGNATURE OUTSIDE NEW YORPETATE in Rooktand County
Commission Expires Feb. 17.20 •
STATE OF
COUNTY OF
ss.:
On
before me
personally
appeared
personally known to me or proved to me on the basis of
satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to within the instrument and
acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/
their signature(s) on the instrument, the individual(s), or the person upon behalf of whom the individual(s)
acted, executed the instrument, and that such individual(s) made such appearance before the Undersigned
in
(state/country).
(signature and office of the individual taking acknowledgement)
ACKNOWLEDGEMENT OF PRINCIPAL'S SIGNATURE IN NEW YORK STATE (for joint accounts)
On
before me,
personally
appeared
personally known to me or proved to me on the basis of satisfactory
evidence to be the individual(s) whose name(s) is (are) subscribed to within the instrument and acknowledged
to me that he/shehhey executed the same in his/her/their capacity(ies), and that by his/her/their signature(s)
on the instrument, the individual(s), or the person upon behalf of whom the individual(s) acted, executed
the instrument.
Notary Public
ACKNOWLEDGEMENT OF PRINCIPAL'S SIGNATURE OUTSIDE NEW YORK STATE (for joint accounts)
STATE OF
COUNTY OF
ss.:
On
before me,
personally
appeared
personally known to me or proved to me on the basis of
satisfactory evidence to be the individuals) whose name(s) is (are) subscribed to within the instrument and
acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/
their signature(s) on the instrument, the individual(s), or the person upon behalf of whom the individual(s)
acted, executed the instrument, and that such individual(s) made such appearance before the Undersigned
in
(state/country).
(signature and office of the individual taking acknowledgement)
5
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CONFIDENTIAL
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• • • IMPORTANT INFORMATION FOR THE AGENT(S):
When you accept the authority granted under this Authorization/Power of Attorney, a special legal relationship
is created between you and the Principal. This relationship imposes on you legal responsibilities that continue
until you resign or the Authorization/Power of Attorney is terminated or revoked. You must:
1. act according to any instructions from the Principal, or, where there are no instructions, in the Principal's
best interest;
2. avoid conflicts that would impair your ability to act in the Principal's best interest;
3. keep the Principal's property separate and distinct from any assets you own or control, unless otherwise
permitted by law;
4. keep a record of all receipts, payments, and transactions conducted for the Principal;
5. disclose your identity as an Agent whenever you act for the Principal by writing or printing the Principal's
name and signing your own name as "Agent" in either of the following manner: (Principal's Name) by
(Your Signature) as Agent, or (Your Signature) as Agent for (Principal's Name); and
6. agree that DBSI shall not be obligated to proceed with instructions that are inconsistent with the terms of
any agreements governing the Account(s) or that would violate any applicable laws, rules or regulations.
You may not use the Principal's assets to benefit yourself or give major gifts to yourself or anyone else
unless the Principal has specifically granted you that authority in this Authorization/Power of Attorney and in
a Statutory Major Gifts Rider which the Principal may attach to this Authorization/Power of Attorney. If you
have that authority, you must act according to any instructions of the Principal or, where there are no such
instructions, in the Principal's best interest. You may resign by giving written notice to the Principal and to
any co-agent, successor agent, or the Principal's guardian if one has been appointed. If there is anything
about this document or your responsibilities that you do not understand, you should seek legal advice.
Liability of Agent: The meaning of authority given to you is defined in New York's General Obligations Law,
Article 5, Title 15. If it is found that you have violated the law or acted outside the authority granted to you
in the Authorization/Power of Attorney, you may be liable under the law for your violation.
AGENT(S)' SIGNATURE AND ACKNOWLEDGEMENT OF APPOINTMENT:
It is not required that the Principal and the Agent(s) sign at the same time, nor that multiple Agents sign
at the same time.
erns
0-4'n ti 4 it
7
I/we,
it
/3
iinsert names} of Agent(s))
Authorization/Power of Attorney.
have read the foregoing
I am/we are
e person(s) identified therein as Agent(s) for
e Principalyfamed therein.
Agent's signature
Dated:
Agent's sig ature
Dated:
iC/K45
CONFIDENTIAL
SDNY_GM_00038817
ii-rwm.0985101/121
CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0001641
EFTA_00 149426
EFTA01283119
ACKNOWLEDGEMENT OF AGENT(S)' SIGNATURE IN NEW YORK STATE
P -c,-- Pa-
ss.:
On
Pitt 3
before me,
A4 r r7 tleAt
personally
appeared jr.g., x..e
f5 I'D 14 1,-4-•-.. personally known to me or proved to me on the basis of satisfactory
evidence to
the individual(s) whose name(s) is (are) subscribed to within the instrument and acknowledged
to me that he/she/they executed the same in his/her/their mpacity(ies), and that by is/her/their signature(s)
on the instrument, the individual(s), or the person upon brit) f of whom.the
ividual(s) acted, executed
the instrument.
HARRY I. BELLER
Notary Public
Notary Public, State of New York
No 018Si:853924
ACKNOWLEDGEMENT OF AGENT(S)' SIGNATURE OUTSIDE NEW YORK STATgommission Expires
Feb.;?, 20.4T
Chini:fiod in Po?,:iland County
STATE OF
COUNTY OF
ss.:
On
before me
personally
appeared
personally known to me or proved to me on the basis of
satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to within the instrument and
acknowledged to me that he/shehhey executed the same in his/her/their capacitylies), and that by his/her/
their signature(s) on the instrument, the individual(s), or the person upon behalf of whom the individual(s)
acted, executed the instrument, and that such individual(s) made such appearance before the Undersigned
in
(state/country).
(signature and office of the individual taking acknowledgement)
ACKNOWLEDGEMENT OF AGENT(S)' SIGNATURE IN NEW YORK STATE (for joint accounts)
Alen(/
<
ss.:
On /0 /5
before me
O
A-tray/6.e a.—
personally
appeared
trie r
personally known to me or proved to me on the basis of satisfactory
evidence to
the
svi ual(s) whose name(s) is (are) subscribed to within the instrument and acknowledged
to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/herhheir signaturefs)
on the instrument, the individual(s), or the person upon behalf of whom the individual(s).actecL executed
YOLANDA RIcHARDS0N
the instrument.
Votary Public. Slate of New Yotk
VI/1.A
--
No. 0lleI6053071
Qualified in Queens County
Notary Public
Commission Spires January 2. 20,45
ACKNOWLEDGEMENT OF AGENT(S)' SIGNATURE OUTSIDE NEW YORK STATE (for joint accounts)
STATE OF
COUNTY OF
ss.:
On
before me,
personalty
appeared
personally known to me or proved to me on the basis of
satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to within the instrument and
acknowledged to me that he/she/hey executed the same in his/her/their capacity(ies), and that by his/her/
their signature(s) on the instrument, the individual(s), or the person upon behalf of whom the individual(s)
acted, executed the instrument, and that such individual(s) made such appearance before the Undersigned
in
(state/country).
(signature and office of the individual taking acknowledgement)
7
11.PWM-090S1Oltla
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DB-SDNY-0001642
EFTA 00149427
EFTA01283120
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Endorsements
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CONFIDENTIAL
SONY_GM_00038819
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0001643
EFTA_00149428
EFTA01283121
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NONE
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CONFIDENTIAL
SDNY_GM_00038820
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0001644
EFTA (X]149429
EFTA01283122