EFTA Document EFTA01345093

Account Transfer Form I. RECEIVING FIRM INFORMATION (Only one per TOM) RECEIVING FIRM CLEARING NUMBER: 0443 ACCOUNT NUMBFR SOCIAL SECURIT ., NUMBER SECONDARY SOCIAL SECURITY NUMBER: - FF1- ACCOUNT TYPE: (Enter the two character code) C 0 or TAXPAYER IDENTIFICATION NUMBER: or TAXPAYER IDENTIFICATION NUMBER: Nonratuemeni. JT-(font) TR —(Trustl CT-(Couustee) CO—(Corporate) CU—(Custodian) ES-(Estate) BC-(Bank Custody) AG—(Agency) Retirement. IR —I traditional IRA' RI—(Roth IRA, DR —(Direct Rollover) RI —IBeneliciary) BR —TEleneficiary Roth IRA) 4K —(401k) El—(Education Savings Account) SI —ISIMPLE IRA) QP-(Qualthed Plan) 4B—(403b) 78—(457 Plan) HS-114eallh Savings Account) 5P-(529 Plan) OT — !Other) Other. I II. DELIVERING ACCOUNT INFORMATION CLEARING NUMBER: ACCOUNT NUMBER: FIRM NAME. JPMorgan Chase Bank, N.A. ACCOUNT TITLE: (As it appears on your statement) Southern Trust Company, Inc NOTE: A complete copy of yet. DELIVERING FIRM CONTACT INFORMATION (MANDATORY WHEN CLEARING NUMBER IS NOT PROVIDED' CONTACT NAME: FIRM ADDRESS. (No PO Box) CITY: STATE: ZIP. TELEPHONE NUMBER: —It statement is necessary to process this form. III. TRANSFER TYPE (Choose only one) A ACCOUNT TRANSFER U FULL 'Check one below) K TRANSFER ALL ASSETS IN KIND (Skip to Seclion VII U LIQUIDAI E ALL ASSETS LISTED IN SECTION IV (Lous:Wane are not for brokerage accounts) U TRANSFER ALL ASSE IS IN KIND EXCEPT FOR THE ASSETS USTED IN SECTION N. WHICH REQUIRE LIQUIDATION U PARTIAL (Complete Section M B. DRS/DRIP U FULL (Check one below) U SELL FRACTIONS AND CLOSE ACCOUNT 0 TRANSFER ALL FULL SHARES ONLY U PARI IAL (List assets in Section NI NOTE: For transler agents. electronically send positions o issue a certificate for whole shares and redeem fractional shares. C. DIRECT MUTUAL FUND 0 TRANSFER MUTUAL FUNDS FROM THE ACCOUNT HELD DIRECILY AI THE FUND COMPANY ISee list in Section IV for exact instructions) NOTE: Only one fund family per form. D. BANK RETIREMENT PLAN ACCOUNTS (Select only one) K LIQUIDATE IMMEDIATELY AND TRANSFER CASH I am aware of and acknowledge any penalty I will incur from an early withdraws. O LIQUIDATE Af MATURITY AND TRANSFER CASH Sootily maturity dale (submit two to litree weeks before maturity date). NOTE: Liquidations involving bank CDs. checking accounts, or savings accounts can only be processed from retirement accounts. SIGNATURE SIGNATURE DATE DATE ul I :WO ISO ACAT u9 IViM-0697 I10.09) Page 2 of 3 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0031206 CONFIDENTIAL SONY GM_00177390 EFTA01345093