Funds Transfer Request or Th 4-a-t Effective Date: (Please Type Instruri. ions) 12/08/12 J.P.Morgan Please enter current or haw° dete only Select Appropiate Payment Type and Fields will be Displayed O JPMC Transfer O ACH 0 Chet< Principal: Originator Itilartitution Debit Account if: =ar r . Receiving Bank ABA: Receiving Bank Name: Beneficiary Account ff: Beneliciary Name: 15228.87 C) Domestic Wire C) International Wiro Income: Address 1: Ja.ritt Debk Account Title: 021000021 JPMorgan Chase Jeffrey E. Epstein Address 2: City: State: Zip Code: #1.71rPUgli'lnlerrned a'y Part? (II Required) Account Type: Intermidiary Bank Account/Code: Intermediary Bank Name: 0 DDA (US) 0 Swift Payment Details (Reference/ Advice Description/Addenda) r Reimbursement for I 'iguana had 0 Other • , Authonz By 11/27/12 Date ID 036212067821783 DATE: 12/06/2012 21 1REpapkt 2 of 2 DID: 11l49 JJ1NDEX1 INDEX2 PAGE 2 OF 2 Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00059792 EFTA01580456