Funds Transfer Request (Please Typa ImtilietiOM) iVN ?-•:rFfef :4?:* .rti ttaili t0 17140 3 14Frat Effective Date: 06/0O3 Please enter CUIleff Of Uwe dale only Select Approptate Payment Type and Fields will be Displayed 0 JPMC Transfer Principal: nraiciWge. er r Ait4oriaia45O Debit Account I: 'in -' • 0 ACM 0 Check 0 Domestic Wire $250,000.00 Receiving Bank ABA: Receiving Bank Name: Beneficiary Account Beneficiary Name: t:3• 91c eii; - • [IP Morgan Chase l Darren K Indyke PLLC la” lb(3W.:7).0:2)141 .1; r1 Parry Of. Account Type: LJ DOA (US) Intormidiary Bank Account/Code: Intermediary Bank Name: Liesitatics ... . - ,..;;.viry;,...,,::',.. .:;::;\<<-',...;•\• 1 Swift Payment Details (Reference/ Advice Description/Addenda) Income: Wert Debit Account Title: . J.P.Morgan 2F5704 1.cygge International Wire Address 1: Address 2: City: State: 0 Other Zip Code: 1 Authorized By [00/03/13 Date ID: 036306067532419 DATE: 06!061201317:24:00 Page 2 of 2 DID: 8887316607 CSID: INDEX1: INDEX2: Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00059519 EFTA01580229