2012-Nov-15 0315 PM BANK OF AMERICA ST 34 Bank of America SP Personal Signature Card BANK OF AMERICA. N.A (THE "BANK") with Substitute Form W-9 Account Number Bank Number: || Account Type: Oo DDA SAV oO cD Account Title: V} Individual Owner 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. [_] Jotnt with Right of Survivorship oO Tenants by Entireties (Form of Joint with Right of Survivorship for spousal co-owners only. Note: Defaults to Jolnt with Right of Survivorstip (f'atate law does aot recogalze Tenants by Entireties for bank accounts.) OWNERSHIP TYPES: Check if designating beneficiaries: OD Payable on Death (POD) / In Trust For (ITF) / Totton Trust (Refer to Beneficiary Addendum for details) Hy wigaing below, live acknowledge and agree that this account is and will be governed by the torms and conditions set forth in the eecount opening documents, mcluding the Deposit Agreement and Disclosures and the Personal Schedule of Fees. I/we acknowledge the receipt of these documents. I/we understand and agree what Uke Hunk may change these documents at any lime by adding now terms, or deleting or ameading sxisting terms. The Deposit Agreement Includes a provision for try inal waiver or reference to a judicial referee. A joint account with right of survivorship is the property of each co-owner and payable to cither co-owner or to the Sur 10 ing CoMMner(s) If a co-owner dics iy checking the box marked “ATM/Debit Card Requested?” Mwe hereby ro en Automatic Teller Machine Card and/or a Debit Card. By signing below, Uwe consent (i the ixsuanve of an A'TM card and/or Debit Card to the othor account holders indicated below. By signing below, I/we acknowledge and agree that the siyyomtare( x) will serve ax verification for arty transection in connection with this account, and es the certification (set forth below) of the taxpayer ident number HTN) Sulevtitute Porm W9 Curtification - Under penalties of perjury, | certify that: (1) The number shown on this form is the correct taxpryer identification number (or | am waiting fora number tw by tentted to me), and (2)! om not subject to backup withholding because: (A) 1] am exempt from backup withholding, or (B) | have not been notified by the Internal Revenue Service (JRS} that | am sebject to backup withholding as # result of a failure to report ail intrest or dividends, or (C) the IRS has notified me that lam no lonper subject to backup withholding; and (3) | ama US citizen or other US person (Defined in the W-9 instructions). Certification Instructions You nuist eros oul item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest andl dividends om your tax return. For real estate trangnetions, item 2 does not epply, For mo Interest paid, acquisition or abandonment of secured property, cuncellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than intorest and dividends, you are not required to sutn the curit{ication, but you must provide your correct TIN. (Please refer to the IRS instructions for Form W-9). The Internal Revenue Service does aot require your consent to any provision of (his document other than the certifications required to avold backup withholding, | Nonresident Allen Status (if applicable) Ifyou and all of the join: owners of this sccount are forcign persons, check hore and complete and sign the epplicable Horints) We © 2012 Bank of America, N.A. All Rights Reserved ANY O81 1929SM_ 08-2012 IMU | WUIUTA U WOU TARA Page 1of2 EFTA00123696

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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, TEXAS, VIRGINIA & NORTH | JOINT OWNERSHIP TYPE SELECTION: | Joint Accounts can be with or without survivorship. With survivorship means upon the death of one Joint owner, the money remaining fn ve account will belong to the surviving joint owner(s), and will not be inherited by the heirs of the deceased joint owner or controlled by the deceused ownur’s will Without survivorship means if one of the owners dies, the deceased owner's ownership Interest in the account passes as part 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): [7] Joint Account - With Survivorship/Tenants by Entireties (with Survivorship for Spouses) OR [[] Joint Account — Without Survivorship Signer Information Customer | _ Account Owner's Signature Date Customer 2, Account Owner's Signature Date Customer 3 Account Owner's Signature Date Customer 4 Account Owner's Signature Dete Customer 5. . Account Owner's Signature Date Custo Nase US Driver Liconse W/Photo Review information Approved Ewisting Customer 2 Name Review Information Customer 3 Name Review Information Customer 4 Name Review Information Customer 5 Name Review Information Baak Information Date Basking Center Name ALLERTON AVENUE . Ansocinte’s Name AliSherifRobinton Associate's Phone Number | NNY asa ame QUAM UAE T= EFTA00123697