EFTA00236475.pdf

UBS Financial Services Inc. * UBS Account Number TIN Authorized Agent/Dual Signor Addendum to add an additional check user on the Resource Management Account' (RMA') or Business Sennces Account est, complete the Authorized Agent for RWVBussriess 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 Oual Signors for RMA/Business Services Account BSA Check Writing and the Account Holder Certification sections The Account Holder must sign the Account Holder Certification section located on the next page. Authorized Agent for AMA/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 or 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 or withdrawal of funds drawn on the designated U8S Financial Services Inc account or payable to me and bearing the signature or signatures now or hereafter authorized by me without limit as to amount, without inquiry and without regard to its application LIBS financial Services Inc *11 send all confirmations notices. demands, statements and other communications regarding checking activity in the designated U8S financial Services Inc account to me UBS financial Services Inc owes no *kw obligations to additional check users and may. but is not required to. ac t on instructions or respond to communications from such additional users Agent first Name Last Name Dale of Birth SW Courtly of Citizenship 2:1 USA 0 Other (specify) Passpcvt/Cedula Address Line 1 Address tine 2 United States of Arnerica City State/Province Zip/Postal Code Count/ Home Phone Additional fees may apply Please see New Account booklet for details Sign Here only if adding an authorized agent Agent First Name Last Name Agent Signature Date Authorized Agent Removal for RM/VBusinms Services Account BSA Check Writing It you are removing an authorized agent, please pint the name of the agent you are removing below Specify Name only it removing an age!): Agent Ng Name t ast Name 0123905W3 tom AP AC •RW (Rev 12/141 02014 UBS Financial Services In: All nights reserved Member SIPC Page It. CONFIDENTIAL UBSTERRAMAR00000786 EFTA00236475  UBS Authorized Agent/Dual Signor Addendum Duel Signors for RMASuumns Services Account BSA Check WriOng Dualtlagnature checks »grim two signatur es at talt times. It you am entraong mete tnan two ugnon wrists to be reduded. Cl all limes please Oseo 'Reoutie0 ma you would Ye Orse crt the nO: »iron» a repo-00 SkysOl. pleat. vacity all 5.9nOis " nest to the ognoes name Ow one memo,» ten de a «pguded wig» you do as optional t1 ~Mull cleSqnile DelOW a«ount notrke, authorized agent. pow« Or adOtrity. elf • also d n not a U8S !manual Sewn» irk men, (hen yyt:ono feat, COMpAeUt the emhonzed Agent lor RMAAhnutess »Does Wove Account BSA (2MKS heft it pOu do NW want VB} !manna! otweeng checkswith dual seralutes U.S Services Inc CO non new duel new», thinks I (heard you net be respons!» tot nnex Senneet not accept single Ctsw&S Såra lxsl Niroe (Mt Name Don Song F st Nan. Stwc ty the type 01 ieer.O. I att SMme gigues 011tronal »Ws the type& »nor -.4 Regret» Cone» Sign Nen GAN fwilling a Dual Signa s. Senor Stylalur• Doe Dual Segna S Swint» Date Note: ton must tomsele and Sign a new addendu m CO ado. ~ow or »Gan *ai »teas U.S Denton Nan,,ce, 'N•Otn Oiled HIclenduin lo ~cede eld wince any omit **A ten on the our,' Clentout due true atkIenclurn on he Account Holder Certification He owing Chao. I uND1RSTANO AC tatt0t al ~CABBIE mat .1 i hive 'Mewed MI of In. credal* it as tree and actuate and ‘2: U3S ;manna, Seems wingmince (Warned in Mis addendum add Feee.rwe• 'cents Inc t eleven an twined Inc M1 authOnted Co tees moon the le led by this 000.enent unlit LIE tow» this tynn. reweng of ~etyma IM 1111Yv'Pit ../- %at last Name , ACC Wee:»1 Segnstare Date gv,ouni how., Litt Name tast Nan. Account Heide Nara.* Date i2»26001 A( ,RIN JO. 02014 LIDS Inancsad Stench ex AM røqnhnryovni Memeet mneiC reChIT SI UBSTERRAMAR00000787 EFTA00236476