Funds Transfer Request (Please Type InstructIon,$) Effective Date: 03/14/13 Please Mot current or future dale only Select Appropiate Payment Type and Fields will bu Displayed 0 JPMC Transfer Principal Debit Amount #: O ACH 0 Check $30,000.00 neceiying Pa lftlOmiatton.,. O Income: J. P. Morgan MaTIreaMair Domestic Wire Debit Account O International Wire Financial Trust Company Receiving Bank ABA: Receiving Bank Name: Beneficiary Account #: Beneficiary Name: Address 1: 221571473 P. O. BOX 9146 FIRST BANK, PUERTO RICO Address 2: 1519 Ponce Do Loon Avenue FINANCIAL TRUST COMPANY. INC City: State: Santurce PR Zip Code: 00948 e,v n•ps, T,tet, Pay;Throughiltaatiftedlary Party.(ftegOladd) • , . Account Type: Intermediary Bank Account/Code: Intermediary Bank Name: 0 DOA (US) C) Swift 0 Other Payment Details (Reference/Descriplion/Addenda) Laifit-4.4 (Payroll transfer Authorized By uthoreCd 03/14/13 Date 1 ID: 036303143401381 DATE 03/14/2013 19 35 00 Page 3 of 3 DID 8887316607 CSID. INDEX1 INDEX2 Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00059655 EFTA01580345