Funds Transfer Request (Reese Type Instruction ) ffi "hrk- rifier U •Itiarts arAnformatiortit ...is-Pqn • Vt..,:e3":-.4Y::',W.t*..".ra Effective Date: 11/16/12 Please erter cArent or future date only Select Appropiate Payment Type and Fields will be Displayed Principal: O JPMC Transfer O ACH O Check $400.00 -inaiSitar ma .r.nforrnation Debit Account Account #: O Income: J.P.Morgan Domestic Wire O International Wire Debit Account Title: Jeffrey E. Epstein Flecciiiin Rs/ ilnf0rmation.O, VloncrAh•CAtt, Receiving Bark ABA: Receiving Bark Name: Beneficiary Account a Beneficiary Name: Address 1: JPMorgan Chase Address 2: City: State: O Othe Zip Code: PayiThrougivinterM Account Type: Intermidiary Bank Account/Code: Intermediary Bank Name: • ;A- adyliViequiradyrs O DDA (US) O Swift Payment Details (Reference/ Advice Description/Addenda) ki74: SWS, Laser skin surgery i Authorized By 11/16/12 Date ID: 036211167189618 DATE 1116201216:33:00 Page 2 of 2 DID: 8887316607 CSID: INDEX1: INDEX2 Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00059815 EFTA01580476