EFTA Document EFTA01344425

Account Transfer Form I. RECEIVING FIRM INFORMATION (Only one per form) RECEIVING FIRM CLEARING NUMBER 0443 ACCOUNT NUMBER: SOCIAL SECURITY NUMBER SECONDARY SOCIAL r SECURITY NUMBER: T 1- ACCOUNT TYPE: (Enter the two character code) C O or TAXPAYER IDENTIFICATION NUMBER: or TAXPAYER IDENTIFICATION NUMBER: 1..1J Nonretiremenc SN—ISinglei —I.loint) TR —(Trusti CT —Manumit.) CO—(Corporate) CU—(Custodian) ES —(Estate) BC- (Bank Custody) AG-tAgency) Retirement: IR — (Traditional IRAI RI—IFloth IRA) DR —(Direct Rollover) BI—(Beneficiary) BR —(Beneficiary Roth IRA) 4K —(40Ik) El—(Education Savings Account) SI —(SIMPLE IRA) QP—(Qualdied Plan) 4B—(403b) 7B—(457 Plan) HS—(Heallh Savings Account) 5P-(525 Plan) OT — tOtheri Other: II. DELIVERING ACCOUNT INFORMATION CLEARING NUMBER: ACCOUNT NUMBER. FIRM NAME: JP Morgan DELIVERING FIRM CONTACT INFORMATION (MANDATORY WHEN CLEARING NUMBER IS NOT PROVIDED) CONTACT NAME' ACCOUNT TITLE. (As it appears on your statement) FIRM ADDRESS: (No PO Box) — — — CITY' STATE: TELEPHONE NUMBER: statement is necessary to process this form. Jeepers Inc. ZIP: III. TRANSFER TYPE (Choose only A. ACCOUNT TRANSFER 0 FULL (Check one below) 0 TRANSFER ALL ASSETS IN KIND (Skip to Section VI) 0 LIQUIDATE ALL ASSE I S LISTED IN SECTION IV (Liquidations are not lor brokerage acoounts) 0 TRANSFER AU. ASSETS IN KIND EXCEPT FOR THE ASSETS USIED IN SECTION N. WHICH REQUIRE LIQUIDATION 0 PARTIAL (Complete Section M B. DRS/DRIP U FULL (Check one below) 0 SELL FRACTIONS AND CLOSE ACCOUNT O TRANSFER ALL FULL SHARES ONLY O PARTIAL (List assets in Section N) NOTE: For transfer agents. electronically send positions or issue a certificate for whole shares and redeem tractional shares. C. DIRECT MUTUAL FUND TRANSFER MUTUAL FUNDS FROM THE ACCOUNT HELD DIRECTLY AT THE FUND COMPANY ISee Est in Section IV for exact instructions) NOTE: Only one fund family per form. D. BANK RETIREMENT PLAN ACCOUNTS (Select only one) O UOUIDATE IMMEDIATELY AND TRANSFER CASH I am aware of and acknowledge any penalty I will incur from an early withdrawal, O UOUIDATE AT MATURITY AND TRANSFER CASH Specify maturity date (submit ❑no to three weeks before maturity date). NOTE: Liquidations involving bank CDs. checking accounts. or savings accounts can only be processed from retirement accounts. SIGNATURE DATE SIGNATURE DATE HY 1! !I RPE)-150 ACAT CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL SDNY_GM_00176033 rcear140.40697 11040) Pate: 2 of 3 DB-SDNY-0029849 EFTA01344425