2012-Nov-15 0315 PM BANK OF AMERICA 14 Bank of ica Persons! Signature Card IKANK OF AMERICANA. (THE "BANK" with Substitute Form W-9 Account Number: Fs Bank Number: ill Account Type: DDA Oo SAV oO cD Account Title: TX, VA, & NC; IF JOINT OWNERS, THE JOINT OWNER SURVIVORSHIP MUST BE SELECTED ON PAGE 2. ALL OTHER STATES: IF JOINT OWNERS, SELECT FROM THE APPROPRIATE SURVIVORSHIP BELOW. (CD soint with Right of Survivorship imi Tenants by Entireties (Form of Joint with Right of Survivorship for spousal co-owners euly. Note: Defaults to Joint with Right of Survivorship if state law does not recognize Tesants by Entiretles for bank accounts.) Check if designating beneficiarivs: oO Payable on Death (POD) / In Trust For (ITF) / Totten Trust (Refer to Beneficiary Addendum for details) Hy styalng below, I/we acknowledge and sgrce that this account ‘6 and will be governed by the terms and conditions got forth in the account opening documents, socluding the Deposit Agreement and Disclasurus and the Personal Schedvle of Fecs. I/we acknowledge the receipt of those documents. I/we understand and agree that the [Wink may change these documents at any time by adding new terms, or delcting or amending existing terms, The Deposit Agreement includes a provision for Jory Irial waiver oF reference to a Judicial referee, A joint account with right of survivorship Is the property of each co-owner and payable to elther co-owner or to the Sure iv ing CO-OWHetts! Ifa co-owner dics. By cheeking the box marked "ATM/Debit Card Requested?” we hereby request an Automatic Teller Machine Card and/or a Debit Cerd. By algning below, Uwe couxent tt the Iywuanee of an ATM card and/or Debit Card (0 the other account holders indicated below, By signing below, I/we acknowledge and agree that the sipnature(s) Will serve as verification for any transaction in connection with this eccount, and as tho certification (set forth below) of the taxpayer identification number crn Substitute Form W- Cortificatuw Under peonltics of perjury, [ certify teat; (1) The number shown on this form Is the correct texpayer ident{floation number (or | am waiting for = numher ter be ineugd to inte): end (2) | am not subject to backap withholding becnuss: (A) lam exempt from backup withholding, or (B) I have not been notifled by the Internal Revenye Service (IRS) that | am subject to backup withholding as « result of g failure to report all Interest or dividends, or (C) the IRS bas notifled me that | am no Honpur subject to backup withsolding, nnd (3) 1am 2 US citizen of other US person (Defined in tho W-9 instructions), Certifeatlon laxtructions You must €ross out item 2 above if you have ben notified by the IRS that you are currently subject to backup withholding because you have falled to report all interest vad dividends on your tux ruler. Mar real estate transactions, ivem 2 doos not apply, For mortgage interest pald, acquisivion or abandonment of secured property, cancellation of dubl, contribytinns to an mdividual retiroment arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sien thy certification, but you must provide your correct TIN, (Please refer to the IRS Instructions for Form W-9 ) Nonresident Atten Stntas (ifappitenble) I you and all ofthe jotnt owners ofthis nseount are foreign persons, check bara and complete and siya the applicable Horns) Wel. Tay 1D Number © 2012 Bank of Amorion, NA. All Rights Reserved NAY rts aman QUT EAC A ee EFTA00123692

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2012-Nov-15 0315 PM BANK oF AMERICA 2/4 TEXAS, VIRGINIA & NORTH | JOINT OWNERSHIP TYPE SELECTION: CAROLINA ONLY: (VATS PROBATE CODE§ 439, VACA §6.2-618, NCGS §53-146.1) During the lifetime of the co-owners of the account, the Bank may pay the money in the account to, or on the order of, any person named on the account, Joint Accounts can be with or without sarvivorship. With survivorship means upon the death of one juint owner, the money remalning in the account will belony to the surviving joint owner(s), and will not be inherited by the heirs of the deceased joint owner or controlled by the deceased owner's will, Without survivorship meang if one of the owners dics, the deceased owner's ownership interest in the account passes us purt of the owner's estate under the owner's will or by intestacy If there is no will. Joint Account Survivorship Selection (Select One of the following options: all owners must sign and date): () Joint Account - With Survivorship/Tenants by Entireties (with Survivorship for Spouses) OR {[] Joint Acoust - Without Survivorship Signer Customer | ee Account Owner's Signature Dae Castomer 2 Te Account Owner's Signature Daw Customer 3 -_ Agoount Owner's Signature Dare Customer 4 — ee Account Owner's Signature Date Customer 5. — $$ ——- Account Owner's Signature Date — Name US Driver Licunse W/Photo Review Information Approved Exi — Customer 2 Bank Ieformation Date }is14i2012 a Banking Center Name ALL! AVENUG Associate's Name Ali-Shan? Robinson ; Associate's Phone Number ki ~~... - 2 NNY covensan cbt QUENT ome EFTA00123693