EFTA00237341.pdf

UBS Financial Services Inc. *UBS Account iNJrnber I IN Authorized Agent/Dual Signor Addendum To add an additional check user on the Resource Management Account (RMA') or Business Services Account 85it, complete the Authorized Agent for RMA/Business Services Account BSA Check Writing and the Account Holder Certification sections. To remove an authorized agent. complete the Authorized Agent Removal and the Account Holder Certification sections If the dual-signature option is selected on the Account Application, complete the Dual Signors for RMAMusiness Services Account BSA Check Wining and the Account Holder Certification sections. The Account Holder must sign the Account Holder Certification section located on the next page. Authorized Agent for RMA/Business Services Account BSA Check Writing Each additional check user (who is not a minor) named below is appointed an agent to me, unaffected by my subsequent disability a incompetence, to effect checking transactions in my designated UBS Financial Services Inc. account. As indicated below, the additional check user is authorized to act on my behalf to write checks for the payment a withdrawal of funds drawn on the designated UBS Financial Services Inc. account a payable to me and bearing the signature or signatures now a hereafter authorized by me without limit as to amount, without inquiry and without regard to its application. UBS Financial Services Inc wil send all confirmations, notices, demands. statements and other communications regarding checking activity in the designated UBS Financial Services Inc. account to me. IJB5 Financial Services Inc. owes no obligations to additional check users and may, but is not required to, act on instructions or respond to communications from such additional users • • • ; • . ; . Robert Kuchner . . . . . • • • • • • Agent First Name Last Name Date of Birth 551 Lisbe4- . • . •Country of Citizenshil E USA 0 Otherspecify). PassporVCedula: -rn1 in . •.' . Address Line 1 Address Line 2 . . . . . . United States of America City State/Province Zip/Postal Code Country Home Phone Additional fees may apply Please see New Account booklet for details. Sign Here only if adding an authorized agent Robert Kuchner X Agent First Name Last Name Agent Signature Date Authorized Agent Removal for RMA/Business Services Account BSA Check Writing If you are removing an authorized agent, please print the name of the agent you are removing below. Specify Name only it removing an agent. Agent First Name Last Name 0159442762 i AC•RW (Rev 1C/15: AMEN O2015 UBS Financial Services Inc. All tights reserved Member SIPC. Page 2 CONFIDENTIAL UBSTERFtAMAR00001704 EFTA00237341