Funds Transfer Request _(Pieaso Type instructions) J. .P Morgan USD Transfer Information Effective Date: 09/25/13 Please enter current or future date only Select Appropiate Payment Type and Fields will be Displayed O JPMC Transfer O ACH O Check © Domestic Wire O International Wire Address 1: State: ma: Code: | Account Type: O DDA (US) O Swift O Other Intermediary Bank Account/Code: Beneficiary Name: Pay Through4intermediary Party. (If Required) Payment Details (Reference/Description/Addenda) Authorized By EFTA00313264