EFTA00123696.pdf

2012-Nov•15 0315 PM BANK OF AMERICA 3,a Bank of America 4 30' Personal Signature Card tir (TIlli "BANK. ) with Substitute Form W-9 Act:Null Number Bank Number: 1eenunt Type: ❑ DDA SAV ❑CD Atternint to Individual Owner TX, VA, & NC: IP JOINT OWNERS, THE JOINT OWNER SURVIVORSHIP MUST BE SELECTED ON PAGEI. a. ALL OTHER STATES: IF JOINT OWNERS, SELECT FROM THE APPROPRIATE SURVIVORSHIP BELOW. LI Joint with Right of Survivorship El Tenants by Entireties (Form of Joint with Right or Survivonhlp tar spousal co-owners only. Note: Defaults to Jett with Right of 3nreivonhip If aisle law does not recognize Tenants by Entireties for beak anoints.) !'hock if designating hcreficiarios: 0 Payable on Death (POD) / in Trust For (ITP) /Totten Trust (Refer to Beneficiary Addendum flu details) It, Jgdng beton, IM e Ileilllowledge and agree that this account is and will be governed by it terns and conditions set forth in the account opening documents, cam Ii dreg die Deposi Agreement and Disclosures and the Person! Schedule of Fees. Uwe aekaowledge the receipt of these document. Uwe understand and agree trim the Bank may change these documents at any time by adding now =Is, or deleting or amending existing terms. The Deposit Atonement includes a prevision tar ton trial newer or reference ton Judicial referee A joint account with nen of sumvorthip it the property of each co-owner and payable to either eo•owner or to the vin n Illp WSW Ire avowtt dice. It, checking the boa marked "ATM/Debit Card Rammed?" Uwe hereby request en Automatic Teller Machine Card and/or a Debit Cud. By algalag below. Uwe consent to ton imam of ea KIM card and/or Debit Card to to other account holders indicated below. By signing below. Ilwe acknowledge aid agree that the ..ipitaturett) will tune to vetificatiott for ally trot eeliOn le connection web this account, and as the cemilleation (Set lath below) of the taxpayer identification norther I IN) Form W.9 'orti - Under penalt' of perjury. I certify that: (I) The number shown an this form is the correct taxpayer identification nutter (or I am welting for a hunter to he tooted to met and (2): am oat subject to backup withholding because: (A) I em exempt Rom backup withholding, or (B) I have not bun notified by the interned Resew Senile: 0RS) that subject to backup witbolding as a result of a failure to repon all ir.torost or dividends, or (C) the IRS has notified nte that I am no !isomer atiltu in backup withholding; and (ill am a (IS citizen or other US person (Def.oed in the W-9 instructions). Vet-lineation instructions You must cross nit item 2 above if yon hove been notified by the IRS tine yet are earready subject m backup withholding because you have failed to report all lateral owl d )ow as return For real acute trusections. Item 2 does not apply. For mortgage interest paid, acquisition or abandonment pretend property, ea r. contributions to an individunt retirement arrangement (IRA), and powally. payments other than interest and dividends, you are not required to the et:null:anon. but you must provide your cermet T:N. (Plum rein to the IRS Instruction tbr Penn W-9). The Intermit lin tee Service doe, not require your cement to any prewision if this doeemene other than the certifications required to at old backup wIthholdktg, ❑ tinrtidesi %lien State Of applicable) Ifyou and all of 11/0 join: omen of this tccourr. am foreign pcnons. chock here and compleu and sign the epolkable I oriole) %V4 ATM,Debtt Card Rpt. In II) 'Timber Tutored Printed Nem Signature Ace Date Request? Check If Yes On Yes/No (Dep. Ate( y) M O:012 D nk of America, N A All Rinks Reserved 111111111111111111111111111111111111111111111 \'.1 I/S.20I2 Fate I of? EFTA00123696 2012 -Nov -15 0315 PM 4i 4 TEXAS. VIRGINIA & NORTH JOINT OWNERSHIP TYPE SELECTION: CAROLINA ONLY; (VATS PROBATE CODE; 439. VACA 06.2-618,NCOS 953.146.1) During the lifetime of the co-owners of the account, the Rank nay pay the money n the account to. or on the order of. any person named on the account, Joint Accounts can be with or without survivorship. With survivorship means upon the death erection% owner, the money remaining In the account will belong to the sun ibinayint owncr(s). and will not be inherited by the heirs of the deceased joint owner or controlled by the deceased owner's will Without survivorship means if one of the owners dies, the deceased owner's ownership Interest in the account passes ne port of the owner's estate under the owner's will or by Intestacy If there Is no will. Joint Account Survivorship Selection (Select One of the following options all owners must shin and date): Joint Account - With Survivorsh.paenants by Entireties (with Survivorship for Spouses) OR ❑ Joint Account —Without Survivorship Saner Information Customer 1 Account Owner's Signeturc Dale Customer 2 Account Owner's Slangier* Date Customer 3 AccountOwner's Signature Date Customer 4 Account Owners Signature Date Customer 5 Account Owners Signature Dale Customer Name US Driver License Witham Review :rferrollon Approved Ereeting Cintomer 2 Wirt Review Indortrorien Customer 3 Name Review totormuion Customer 4 Name Review Information CustomerS Name Review Inthrmation Hank InPormatkor note 11114/2012 Bseking Center Name ALUIRTON AVENUE Associate's Name Ali-Sherif Weaker Associates Pbone Number NH? 00.14.929SM 084012 fain .t EFTA00123697