m Account Name' Q Issue a check in the amount of $ RcOiJairsNane. Rimpicnt's Mailing Addres.s- pd/able to 1 at Ret^iving Firm Account Number. Qiy/Symboi/Sccu>ilv Oly/Symboi/Sccuiilv EFTA01401436 Standing Authoritation K The undersigned hereby requests that this authonkalion act as a standing aulhoiik