eiving Firm; Check Q Issue a check in the amount of $ Recipient's Name: Rectpienfs Maiing Address; Account Name; payable to: Account Number: Qly/Symbd/Socu rity: Qty/Symbol/Bscu rity: EFTA01404033 at Receiving Firm Startding Aulhotizalion r] The undersigned hereby requests that this authorization a