G Issue a check in the amount of S Recipient's Name: Reopent's Mading Address - payable to: at Receiving Firm Account Number: EFTA01403888 Qiy/Svmbol/Sccuiity: plV/SvmboWSecurity: Standing Auihoriiation G The undeisigned hereby requests that this aulhorisalion eel as a standing aulhorization. The unders