EFTA Document EFTA01392913

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: TIN of Age Relationsh