: City: State: Zip Code: Thmucruli deunSiory Forty. If Ri;:l,tri red) Account Type: Interrnatiary Bank Account/Code: Intermediary Bank Name: IDS DDA (US) 0 Swift Payment Details (Reference/ Advice Description/Addenda) 0 Other Exp. reimbursement statement June 7. 2013 Authorized By 0429113