Signature Card Deutsche Bank Trust Company Americas Account Holder Title Individual Joint, with Rights of Survivorship Signature Signature Signature Signature Approved Power of Attorney Specimen Signature * For ITF/POD/ATF See Supplemental Terms and Conditions Date of Power of Attorney Account Number ITF/POD/ATF* Joint, Tenants in Common Corporate Partnership Limited Liability Corporation Other: Print Name Print Name Print Name Print Name Date Number of Signatures Required: ;$1M178934 006678.062817 EFTA01416101