EFTA Document EFTA01386965

1 First Bank Transfer Application BRANCH NO. PREFIX TEST KEY DATE TIME TRANSFER TYPE: ID WIRE O CABLE O DRAFT O Mail to Customer O Mall to Payee I: Send to Branch REP SIGNATURES (Complete appr date boxes): KEY TMODIFY MODIFY APPROVE IF TRANSFERRING FOREIGN CURRENCY: CONTRACT NO VALUE DATE CONVERSION RATE CONVERTED BY (Initials) TRANSFER AMOUNT (FOR BANK USE ONLY) FOREIGN CURRENCY (Type and Amount) TRADER'S NAME U.S. DOLLARS $ 52,500.00 MOTEL • Eamon currency anoin