VERIFICATION OF DEPOSIT REQUEST - MUFG Union Bank

REQUESTOR INFORMATION

TYPE OF REQUEST

REQUESTOR/COMPANY NAME

VERIFICATION OF DEPOSIT REQUEST

REFERENCE NO. 1570800514049019

RETURN METHOD (Select ONE)

DATE:

01/24/2019

ATTENTION

EMAIL ADDRESS FOR CONFIRMATION OF RECEIPT

ADDRESS

CITY

STATE

PROVINCE/COUNTRY

POSTAL CODE

TELEPHONE NUMBER

FAX NUMBER

CUSTOMER INFORMATION

CUSTOMER NAME (First Name, Last Name OR Company Name) 1.

2. PURPOSE FOR REQUESTED (Consumer Request Only)

W-8 On File

SSNTAX ID (Last 4 Digits)

Authorization

Attached

Select One

CHECKING/SAVINGS ACCOUNT TO CHARGE

IwfIfwtotohirhrismsomotl,ltlh,lyhyeee-e-aooapcwpwcohohnnllieaiceacdydy""VosVsoeufeufrbMrbMiifsfsiUiciUciddaFaFiiatGatiGiororyynUnU"o"on))nffidiodBoBiniranraeenBncBckkattal,l,ynynttkotokto,o,ddNNtetheh.l.AelieAivv.e.R(eR("r"reBeBtqtahqhauneuenekekcsc"s"o)to)t,om,omararpnp/n/ldlAedAetdBtdeBeddaddarrnenerrkeskesqssaqaeuefuffeefeieilslisia((at"t"tRtfRefeooseesrr,qq,ViVuuinneeeeccrrslsiluiftuftioidcocdrairain""nt)t)giigoonnnUnaUamnomnoifiofeeoDnDddnBeeBttphahpaoeneonsrcrsceeiitItisiInnsnn.v(.v(weTwTeshhhshteetememtthBBeheeaneanrntrntokSokSnneeeertxxrtvhhvppieicerrceeeBeBssssasa,s,nlnlLyyLkkLL'dd'sCsCiiss,oo,ccawwallaanSniSimmEfEfoosCsCrrmamarrneneoyogygrririsroseoettnesnseprpraeaoeodnndnnosbsobinirnbbro-o-iiUlkUlikitetnyenyriri-owow-ddnnheheaBaaBatltaselasenornorkekeaavvnrrneeeeddqrrqautautooeesastnt y paenrysopner(swointh(owuitthreoguat rrdegtoarwdhtoetwhehresthuecrhspuecrhsopnerissonnaims endamase,doar sp,uorpr oprutsrptoortbset,oabRe,eaquReesqtoure),swtohr)o, dwoheosdnooetsrencoet irveecaeivceomapcloemtepdleVteerdifiVceartiioficnadtiiorencdtliyrefrcotlmy ftrhoemBtahnek. Bank.

By signing below, I/we authorize and direct the Bank to provide the Requestor the account information, I/we requested below. I/we understand and agree that: a) tBhey sBiagnnkinwg ibllesleonwd, It/hweecaoumthpoleritzeedaVnedridficiraetciot nthdeirBeacntlyk ttoo tphreovRideequtheestRore;qbu)etshteorctohmepaleccteodunVteirniffiocramtioantiomn,aIy/wneotrebqeuuesseteddobtheelor wth.aIn/wfoeruthnedeinrstetannddedanpdurapgorseee; tch)aat:nay) cthoepyBtahnekrewoifllpsreonvdidethdetocommep/luestewdilVl beeriaficr aaticoonndsipreiccutloyutsoltehgeeRndeqpuroehsitboirt;inbg) tthhee ucosemtphleetreedofVfeorrifaicnaytipounrpmoasyenboyt abneyupseerdsoonthoetrhtehratnhafonrtthheeRineteqnudeestdorp;udr)poifsteh;ec) any icnofoprymtahteiorenopfrporvoidvieddedhetoreminei/sunsowt iallcbceuarar taecaonndspcoicmuopulesteleagnedndsupbromhitibteitdinign tahetimuseelytmhearnenoef rf,otrhaenByapnukrpwoisllebebyuannayblpeetrosopnrooctehsesr tthheanVethreificRaetiqouneasntodr;wdi)ll inf othtereintufornromr aretisopnopnrdovtoidtehdehoerrigeiinnailsrneoqtuaecsct;uera) ttehiasnrdeqcuoemspt lfeotremaenxdpsiruebsmointtethdein90athtimcaelleynmdaarnndeary, athfteerBtahnekinwitiilal bl deautenaI/bwleetcoreparotecdesthsethreeqVueersifticealteiocntroannidcawllyill; naontdref)tuifrIn/woer do nreost porindt atondthseeonrdigtionathl ereBqaunekstv; iea)ftahxis, breqfourestthfeorrmeqeuxepsitreesxpoinretsh,ea9n0dtheicthaeler:n(di)aar dcaoypyafotef rththeeBiannitkia'sl dVaeterifIic/waetiocnreoaftDedepthoesirterqeuqeusetset lfeocrmtro, nbiecarlliyn;gamndy/fo)uifr I/we do snigont aptruinrteas,nodrs(eiin) da tcootphyeoBf aannkovnia-Bfanxk, breqfourestthfeorrevqeuriefisctaetioxpniroefsd,eapnodseit,ithbera:r(ini)gamcyop/oyuorfstihgenaBtaunreks's, tVheernifiIc/awteiown iollfhDaevpeotositrerepqeuaet stht efoprmro,cbeesas,ribneggminyn/ionugr wsigthnantuerwesr,eoqrue(isi)t.a copy of a non-Bank request for verification of deposit, bearing my /our signatures, then I/we will have to repeat the process, beginning with a new request.

In consideration of the Bank's acting on my/our herein request, I/we agree to release and hold the Bank harmless from any and all liability except that caused sInolecolynbsyidietsraotiwon ogfrothses nBeagnlkig'senacetinogr ownillmfuyl /mouisrchoenrdeuinctr.eIq/wueesftu, rIt/hweer aaggrreeee ttoo rpealeyatshee aanpdplhicoaldblethfeeeBafonrkthearVmelerisfiscafrtoiomn asnyseatnfdorathll liinabthileityBeaxncke'sptdtihscaltocsauuressedand asgorleelymbeynits aonwdnrgerlaotsesdnfegelisgcehnecdeuolerswfiollrfuplemrsisocnoanldauncdt.buI/swineefsusrthderpaogsirteaectcoopuanytsthineeaffpepclticfarobmle tfiemeefotor thimeeV.erIi/fwiceatuionndearssstaent dfotrhthatinI/wtheehBaavnekt'hsedrisigchlotstourreesvoakned tahgisreaeumtheonritzsaatinodn raetlaatneydtfiemeesbcehfeodreultehsefoBrapnekrhsoansasleanntdthbeucsoinmespsledteedpoVseitriaficacotiounttsointheffReectqfureosmtotrim. e to time. I/we understand that I/we have the right to revoke

this authorization at any time before the Bank has sent the completed Verification to the Requestor. I/we acknowledge and agree that: (i) I/we can request, on the online Verification of Deposit Request form itself, email confirmation that the Bank has received mI/wy/eouarcrkenqouwelsetd,gaendan(idi)aI/gwreeecathnact:o(ni)taI/cwtethceaBnarenqk'useTset,leopnhtohneeoBnlainnekiVngerDifiecpaatiortnmoefnDt aetp(o8s0it0R) 2e3q8u-e4s4t8fo6rtmo iintsqeulfi,reemabaoiluctothnefirsmtaattuiosnotfhmatyt/hoeurBraenqkuehsats. received

my/our request, and (ii) I/we can contact the Bank's Telephone Banking Department at (800) 238-4486 to inquire about the status of my/our request.

X

SIGNATURE

/ /

CUSTOMER DATE

X

SIGNATURE

/ /

CUSTOMER DATE

ACCOUNT TYPE (Select One)

ACCOUNT NUMBER

BALANCE AS OF TYPE

FROMDATE (MM/DD/YYYY)

TO DATE (MM/DD/YYYY)

COLLATERAL DESCRIPTION (CPA Loan Requests Only)

00548 (07/2014) eForm

FAX NUMBER: 1 (714) 985-5936

CUSTOMER NAME:

REFERENCE NO. 1570800514049019

FAX to: (714) 985-5936

Please review your package to ensure that the following information is contained in the documents: ? Union Bank's Verification of Deposit Request Form ? Signed and dated customer authorization (If applicable)

If you have any questions, please visit the Union Bank's website at vod This communication (including any attachments) may contain privileged or confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient you should shred the materials and attachments, and you are hereby notified that any disclosure, copying, or distribution of this communication or the taking of any action based on it, is strictly prohibited. Thank you.

?2014 MUFG Union Bank, N.A. All rights reserved. Member FDIC. Union Bank is a registered trademark and brand name of MUFG Union Bank, N.A.

00548 (07/2014) eForm

FAX to: (714) 985-5936

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