Funds Transfer Request (Please Type In*POWS) J.P Morgan 'Jeffrey E. Epstein Effective Date: 09//0113 measo ram eurrom or inn dale only Select Appropiate Payment Type and Fields will be Displayed O JPMC Transfer Principal Debit Account 0: ±.kWaihtig. Receiving Bank ABA: Receiving Bank Name: Beneficiary Account #: Beneficiary Name: Account Type: Intermidiary Bank Account/Code: Intermediary Bank Name: ;k1;;:ict4 Payment Details (Reference! Advice Description/Addenda) O ACH O Check 55,629.20 Income: Domestic Wire Debit Account The: JPMorgan Chase Ronald Rogers O DDA (US) O International Wire Address 1: Address 2: City: State. vArtZ , ft1,4A-tOrZeJe O Other Zip Code: nitaTtial Fee 8 Reimbursement of Expenses - LSJE 09/10/13 Date ID. 036309102935214 DATE 09/10/2013 15 54:00 Page 4 of 4 DID: 8887316607 CSID: INDEX1: INDEX2 Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00058723 EFTA01579551