Q Issue a check in the amount of $ Recipient's Name: Reapient's Mating Address: Account Name: payable to: Account Number: at Receiving Firm Qty/Symbo I/Security: Qiy/Symbot/Secunty: EFTA01400554 Stankng Authorizatnn G fhe undersigned hereby requests that this authorization act as a standing a

Q Issue a check in the amount of $ Recipient's Name: Recipient's Mailing Address: Account Name: payable to: at Receiving Firm Account Number: Qty/Symbo I/Security: Qty/Symbo I/Security: Standing Authorization Q The undersigned hereby requests that this authorization act as a standing authorization

c Q Issue a check in the amount of $ Recipient's Name: Recipient's Maiing Address: payable to: Account Number: at Receiving Frm EFTA01402543 Qty/Symbo I/Security: Qty/Symbot/Seaurity; Stancfing Authcrizabon Q The undersigned hereby requests that this authorization act as a standing authorization