Funds Transfer Request (Please l roe instructions) Please star curren. a future slate orsy Select Appropate Payment Type and Fields mil be Displayed O JPMC Transfer O ACH O Check O Domestic Wire O International Wire Principal: $529.96 'name: ,giriator information Debit Account S: Debit Account The: Jeffrey E. Epstein Effective Date: 01/15/13 J.P. Morgan aciikr.,? j .inforrnallon Receiving Bank ABA: Receiving Bank Name: IJPMorgan Chase Beneficiary Account #: Beneficiary Name: Address 1: Address 2: City: State: Zip Code: Pay IrrouglifIntermed ary Parly (It lieltred) Account Type: Intermidiary Bank Account/Code: Intermediary Sank Name: O DDA (U$) O Swift Payment Details (Reference/ Advice Description/Addenda) O Other Reimbursement for St Bar, shopping Autho k b#11 ed By 01/15/13 Date ID: 036301169480157 DATE: 0V16/2013 16:37:00 Page 2 of 2 DID: 8887316607 GSM: INDEXI: 1N0EX2 Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00059738 EFTA01580412