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4 ' I 5 I 3 7 3 0 8- 2 5 6 Exp. Date I r r 19 Secunty Code: 3 5 7 OR American Express Exp Date I Seemly Code: Name as it appears On The Md. Darren K. Indyke Riling Address- ay. NV Stale NY Zip: 10022 Signature: 53 Customer Wetter. Baling. P.O.. Project or Reference Codes: :X COI tier Ca() Ser vide P
ntacted in the *tent of an emergency NM* DARREN INDYKE Address SucebRFD a or P.O. Box Aparenenteine C
I Seemly Code: Name as it appears On The Md. Darren K. Indyke Riling Address- ay. NV Stale NY Zip: 1
I Seemly Code: Name as it appears On The Md. Darren K. Indyke Riling Address- ay. NV Stale NY Zip: 10
tact Phone Numbers Ng, ev COI /Inv Oita. 'Ph* It Permanent Address: If P O. Box is listed under Mailing Address zit residence is different from Maiing Address. Street/RFD* or URB (No P.O. Box) Apartinentillra Stale Zip Code IS. Emergency Contact • Provide the informs Pion ofa person not traveling mlh y
r securities to any accountfs) pursuant to this authorization vylthd^ wrin^^ ructions bearing original algnaturefs) of the undersigned. vJjjMifUA Darren K Indyke 09-29-15 Print Name Signature Date Print Name Signature Date III I III III II III III LOA 10-PWM-01775 (12/10) EFTA01403050
naturefs) of the undersigned. vJjjMifUA Darren K Indyke 09-29-15 Print Name Signature Date Print Nam
inal algnaturefs) of the undersigned. vJjjMifUA Darren K Indyke 09-29-15 Print Name Signature Date Pr
Additianal InstnxSions: OTCC#: Name of Receiving Firm: Account Name; Chedc Q Issue a check in the amount of S Recipient's Name: Recipient's Maiing Address; paieWeto; Account Number at Receiving Firm Qty/Symbol/Securttv; Oty/Svm bol/Security; EFTA01403048 SmdhgAuthcriaalion Q The undersigned her
or securities to any aecount(s) pti^ant to Ihis authorization wilhbui ^tten in^iu^bq^aaring original signaturefs) of the undersigned. 6-26-2014 Darren K Indyke 'V Rate Print Name Signature Date Pnnt Name Signature IIMillill1111111l LOA 10-PWMJJ177S (12/10) Iv I EFTA01404660
aturefs) of the undersigned. 6-26-2014 Darren K Indyke 'V Rate Print Name Signature Date Pnnt Name
nal signaturefs) of the undersigned. 6-26-2014 Darren K Indyke 'V Rate Print Name Signature Date Pn
to; AdEftional Instnictbns; DTCC# Name of Receiving Firm: Account Name: Check Q Issue a check in the amount of S Redpient's Name: Reapient's Maiing Address; foyable to: Account Number: at Receh/rng Firm EFTA01404658 OiV/Symbol/Securiiy: Qty/Symbrtl/Socurity: Slandino Autiuivatioti Q The undersig
Entities connected to both Darren Indyke and Maiing Address