Standing Instructions for Funds Transfer

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1 Standing Instructions for Funds Transfer To ensure accuracy, please print all information clearly. Please complete required information on Sections I, II and III, read the terms of the attached Standing Instructions Funds Transfer Agreement and sign and date in Section IV below. I. Client (Originator) Information Client (Originator) Name: Account Number*: Country of Residence: *Federal regulations require us to limit the number of transfers from any savings account, including money market accounts. Please refer to the Client Manual for more information. II. Standing Instruction Information On the date(s) listed below, please effect standing/recurring instructions for the account listed above as follows: Funds Transfer Frequency (select one of the options below) Monthly Weekly Twice-a-Month* Starting date / / Continue until: A certain number of wires have been completed (enter number) A certain date (enter date) / / Until cancelled (mm/dd/yyyy) (mm/dd/yyyy) *For Twice a Month funds Transfers indicate the two dates of the month on which transfers will be sent (e.g. 15th, 30th) First date Second date III. Funds Transfer Information Funds Transfer Amount (in figures) Funds Transfer Amount (in words) Beneficiary Bank Name Beneficiary Bank Address Line 1 ABA / Routing Number Beneficiary Bank Address Line 2 Beneficiary Name Account Number For Further Credit (if applicable) Beneficiary name Account Number (if applicable) Special instructions (if applicable) IV. Authorization and Agreement To Terms and Conditions By signing below, I confirm that I have received a copy of the Standing Instructions Funds Transfer Agreement ("Agreement"). I confirm that I have read, understand and agree to the terms and conditions of the Agreement on behalf of all Account Owners on the account identified in Section I of this Standing Instructions for Funds Transfer form. I also acknowledge that this Instruction shall be processed pursuant to the terms and conditions of the Agreement. Signature / / Date (mm/dd/yyyy)

2 Please send the original, signed, Instruction form to: If by mail: If by courier: Citibank, N.A. Citibank, N.A. P.O Box Citigroup Center, Building A1-03 Tampa, FL Tampa, Florida If you require assistance in completing this form, please contact us as described below*: Business/Service CitiPhone Banking available 24 hours a day, 7 days a week Citigold Private Client Contact your Private Client Advisor or: (813) (877) Citigold International Contact your Financial Consultant or: (813) or 1 (866) International Personal Banking (813) or 1 (877) Global Executive Banking: Citi Global Executive Account Package (813) or 1 (866) Citi Global Executive Preferred Account Package (813) or 1 (866) *Telephone numbers starting with 1 (800) or 1 (866) are toll-free within the U.S. For Text Telephone at (TTY) please call 1 (800) is a service unit of Citibank, N.A. serving Citigold Private Client, Citigold International, International Personal Banking and Global Executive Banking clients at Citibank, N.A. Banking products and services are provided by Citibank, N.A., Member FDIC Citibank, N.A., Member FDIC. Citi, Citibank, Citi with Arc Design, and Citigold are registered service marks of Citigroup Inc. or its affiliates. AHS FDAGR 01013

3 Standing Instructions Funds Transfer Agreement This Agreement sets forth the terms and conditions under which the Client (hereafter referred to as I, me, or my ) identified in Section I of the attached Standing Instruction for Funds Transfer form (hereafter referred to as Instruction ) may instruct Citibank, N.A. (hereafter referred to as Citibank, we, or our ) to execute a future-dated single or recurring funds transfer hereafter referred to as Standing Instructions Funds Transfer or SI Funds Transfer ) from the account identified in Section I of the attached Instruction) to another account internally within Citibank or to an external account with another financial institution as identified in Section III of the attached Instruction. This Agreement also applies to certain funds transfer requests referred to herein as Remittance Transfers. A Remittance Transfer is an electronic transfer of funds initiated from a consumer account located in the United States primarily for personal, family or household purposes to a designated recipient (hereafter referred to as beneficiary ) located outside the United States. Beginning on October 28, 2013, federal law will provide certain rights for Remittance Transfers. As noted throughout this Agreement, different rules apply to Remittance Transfers. Also, for each Remittance Transfer that I initiate, Citibank will provide me with certain disclosures required by federal law at the time I initiate the transfer. To the extent the provisions of this Agreement are inconsistent with the disclosures provided to me for a Remittance Transfer, the provisions of such disclosures shall govern. PLEASE NOTE: Effective October 28, 2013, Citibank will be unable to accept new SI Funds Transfer requests for the execution of a future-dated international wire transfer(s) from a consumer account until further notice. As used in this Agreement, the term business day means any day that is not a Saturday, Sunday, or bank holiday. 1. AUTHORITY TO TRANSFER FUNDS I authorize Citibank to execute and charge to my account any SI Funds Transfers made on the attached Instruction to transfer funds, provided such Instruction is duly completed and executed by an authorized signer of the account in accordance with the procedures established by Citibank. I understand and acknowledge that Citibank has no obligation to execute any SI Funds Transfer that is not initiated in accordance with such procedures. This authorization applies to the account identified on the Instruction in Section I. I further authorize Citibank to charge such account for any applicable service fees for SI Funds Transfers in accordance with Citibank s fee schedule in effect at the time of my SI Funds Transfer or in accordance with any disclosures I receive at the time of my SI Funds Transfer. 2. STANDING INSTRUCTIONS FUNDS TRANSFER REQUESTS I understand that to authorize a SI Funds Transfer, I must complete and send an original signed copy of this Agreement and Instruction to the at: If by mail: If by courier: Citibank N.A. Citibank, N.A. P.O Box Citigroup Center, Building A1-03 Tampa, FL Tampa, Florida SECURITY PROCEDURES For Remittance Transfers, Citibank personnel will perform a call back to any of the signers of the account at the telephone numbers registered with Citibank to provide certain disclosures required by regulation. For all funds transfer requests including Remittance Transfers, Citibank may perform a call back to an authorized signer to verify the request. I may also be required to provide Citibank with written and signed instructions from an authorized signer designated below. I agree that Citibank will not be liable for any delay in processing my funds transfer resulting from compliance with these security procedures. I agree that the use of these security procedures to verify that my instructions have been properly authorized is commercially reasonable for me. I further understand that the security procedure is designed to verify the source of the request and not to detect errors in the content of my instruction. I further agree to notify Citibank promptly of any changes to the information provided by me in this agreement or any schedule thereto. Any such notice must be in writing and sent to one of the addresses listed in Section 2 of this Agreement: 4. INFORMATION SUPPLIED BY CLIENT I agree that Citibank will rely on the information I have provided in the Instruction to execute the SI Funds Transfer. I understand that it is my responsibility to provide Citibank with accurate information regarding that transfer, including the account number of the beneficiary of the funds transfer (such as IBAN ) and where applicable, the number (such as BIC or SORT ) identifying the beneficiary institution, since payment will be processed based on the number(s) provided by me. Should I provide an incorrect account number and/or beneficiary bank identifier, I understand that any losses resulting from the funds being credited to the wrong account will be my responsibility. For Remittance Transfers, I will be required at the time I initiate the request to provide Citibank with information regarding the currency in which the beneficiary account is maintained. I understand and acknowledge that Citibank will rely on this information in executing my instructions in accordance with the provisions set forth in Section 11 Currency of Transfer of this Agreement. AHSTINST 11/13 1

4 5. EXECUTION OF A STANDING INSTRUCTIONS FUNDS TRANSFER REQUEST If the date of a SI Funds Transfer falls on a day that is not a business day, I understand that my request will be executed on the next business day. Citibank will make the determination to pay or reject my funds transfer request on the day on which it is executed based on my available balance at the time the funds transfer request is processed. Effective October 28, 2013, Citibank will be unable to accept new standing instructions for the execution of a future-dated international wire transfer(s) from a consumer account. Should this service resume, the dates on which these future transfers will be executed will be described in the disclosures that are provided to me when I establish such a transfer or transfers in accordance with federal law. Citibank will continue to accept new instructions for a future-dated domestic wire transfer(s) from a consumer account after October 28, REJECTION OF FUNDS TRANSFER REQUEST Citibank reserves the right to reject my request for a funds transfer if I have insufficient available funds in my account, if my instruction is received by Citibank by a communication means not authorized by the bank, if my instruction is unclear or incomplete, if Citibank is unable to verify my funds transfer request, or if for any reason the request is unsatisfactory to Citibank. Beginning September 30, 2013, Citibank will be providing me with certain mandatory disclosures in connection with any requests to send a Remittance Transfer. If Citibank is unable to reach me and provide me with these disclosures, it will be necessary for Citibank to reject my funds transfer request. 7. RESPONSIBILITY FOR FUNDS TRANSFERS To the fullest extent permitted by law, I agree to assume full responsibility and be bound by all funds transfer requests issued in my name, whether or not authorized, provided the funds transfer was executed by Citibank in good faith and in accordance with the procedures set forth in this agreement. 8. DELAYS, NON-EXECUTION OF FUNDS TRANSFER REQUESTS While Citibank will handle my funds transfer request as expeditiously as possible, I agree that Citibank will not be responsible for any delay or failure to execute my funds transfer request, or delay in making the funds available to the beneficiary due to circumstances beyond the control of Citibank or any intermediary or beneficiary bank handling the transfer, including, without limitation, any inaccuracy, interruption, delay in transmission, or failure in the means of transmission of my funds transfer request to the bank or execution of such request by the bank, whether caused by strikes, power failures, equipment malfunctions, or delays caused by one or more institution s fraud screening procedures or compliance procedures for anti-money laundering, economic sanctions or similar laws. I further agree that you may refuse to process or delay processing any request if it would violate any guideline, rule, policy, or regulation of any government authority or funds transfer system. TO THE EXTENT PERMITTED BY LAW, CITIBANK MAKES NO WARRANTIES, EXPRESS OR IMPLIED, WITH RESPECT TO ANY MATTER IN CONNECTION WITH MY FUNDS TRANSFER. 9. INDEMNITY In consideration of the agreement by Citibank to act upon SI Funds Transfer requests in the manner provided in this Agreement, I agree to the fullest extent permitted by applicable law to indemnify and hold Citibank harmless from and against any and all claims, suits, judgments, execution, liabilities, losses, damages, costs, and expenses-including reasonable attorney s fees - in connection with funds transfers made pursuant to this Agreement. This indemnity will not be effective to relieve and indemnify Citibank against its gross negligence, bad faith, willful misconduct, or as otherwise provided by law. 10. DESIGNATION OF BENEFICIARY BANK FOR EXTERNAL FUNDS TRANSFERS When I instruct Citibank to execute an external funds transfer, I must specify a financial institution (hereafter referred to as Beneficiary Bank ) in Section III of the Instruction to receive it. For such transfers within the United States, the Beneficiary (recipient) Bank must be a member of the Federal Reserve System, Clearing House Interbank Payment System (CHIPS), or a correspondent bank of such a member. I may request the Beneficiary Bank to credit an account or to hold the funds for the beneficiary. In either case, the Beneficiary Bank is responsible for following my instructions and notifying the beneficiary when the funds become available. If I identify a beneficiary by name and account number, the Beneficiary Bank may pay the funds to the person identified by the account number and my payment may be final even if the account number provided by me does not correspond to the beneficiary. (The Beneficiary Bank is not obligated to verify that the account number belongs to your beneficiary.) If the Beneficiary Bank is unable to locate an account, the funds may be returned. Except as may be prohibited by applicable federal law for Remittance Transfers, any losses resulting from any incorrect information I provide regarding my beneficiary are my responsibility. 11. CURRENCY OF TRANSFER Funds transfers to beneficiaries within the United States are made only in U.S. dollars. For Remittance Transfers, at the time I request a funds transfer, Citibank will ask me whether the account maintained at the beneficiary bank is held in U.S. dollars or in the local currency where the account is maintained. If I indicate that the account is held in U.S. dollars, my funds transfer must be made in U.S. dollars. If I indicate that the account is held in the local currency of the country where the account is maintained, Citibank will send my funds transfer in that local foreign currency unless the transfer in foreign currency is prohibited by local restrictions of the destination country. If I indicate I do not know the currency in which the beneficiary account is held, I can choose to send the funds transfer in U.S. dollars or in the local currency of the country where the beneficiary account is held. I understand that Citibank will rely on my statement as to the currency of the beneficiary account and will provide me with information about the transfer based on the currency I have indicated for that transfer. I understand that Citibank will not be responsible for any error in the information it provides me concerning the applicable exchange rate and the amount of funds to be received by the beneficiary should my statement as to the currency of AHSTINST 11/13 2

5 the beneficiary account be incorrect and a currency conversion occurs after Citibank sends my funds transfer request. For transfers in foreign currency, Citibank will convert my U.S. dollar payment to the local currency at Citibank s exchange rate in effect at that time for similar transactions. The exchange rate includes a commission to Citibank for exchanging the currency. Information regarding the applicable exchange rate will be provided to me at the time I initiate the transfer. 12. MEANS OF TRANSFER To make external funds transfers, Citibank uses a variety of banking channels and facilities but will ordinarily use electronic means. I agree that Citibank may choose any conventional means that Citibank deems suitable to transfer my funds to the beneficiary. Because Citibank does not maintain banking relations with every bank, it may be necessary to use one or more intermediary banks before the funds are transferred to the beneficiary bank. After Citibank transmits the funds transfer to the intermediary bank, it will be that bank s responsibility to ensure that the funds transfer is completed. I understand that there may be fees imposed by these other banks for handling my funds transfer and that these fees may be deducted from the transfer amount before it is credited to the beneficiary. Effective September 28, 2013, for Remittance Transfers I will be provided with more detailed information regarding applicable fees at the time of my funds transfer request. 13. CANCELLATION OR AMENDMENT OF REMITTANCE TRANSFERS requested on or after October 28, I have the right to cancel or amend my Remittance Transfer provided that I cancel or amend my request within thirty (30) minutes of my authorizing payment for that transfer. If I request a cancellation or amendment after this time, the provisions in Paragraph 14 below applicable to all other funds transfer requests will apply. 14. CANCELLATION OR AMENDMENT OF ALL OTHER FUNDS TRANSFER REQUESTS (including Standing Instructions Funds Transfers for Remittance Transfers established before October 28, 2013): I may cancel or amend my funds transfer request only if you receive my request prior to your execution of the funds transfer request and at a time that provides you with a reasonable opportunity to act upon that request. If my funds transfer request has already been executed by Citibank, I understand and agree that the request to cancel or amend the funds transfer will be effective with the voluntary consent of Citibank and the beneficiary bank. Citibank will first have to check with the beneficiary bank to determine whether or not the beneficiary bank will return my funds. If the beneficiary bank confirms that the funds are returnable and the funds are returned to Citibank, Citibank will return the funds to me. The amount that is returned to me may be less than I originally transferred because of service charges of the beneficiary bank and/or Citibank. My returned funds will be in U.S. dollars. If my funds transfer was in a foreign currency, my returned funds will be in U.S. dollars at the exchange rate established by Citibank on the date of return. Citibank shall not be liable to me for any loss resulting from the failure of the beneficiary bank to accept a cancellation or amendment of my funds transfer request. 15. CLAIMS WITH RESPECT TO REMITTANCE TRANSFERS MADE ON OR AFTER OCTOBER 28, 2013 If I believe there has been an error or I need more information about my funds transfer, I agree that I must contact Citibank within one hundred and eighty (180) days of the date indicated by Citibank that the funds would be available to the beneficiary of that transfer. At that time, I may be asked to provide the following information: 1) my name, address and account number; 2) the name of the person receiving the funds, and if I know it, his or her telephone number or address; 3) the dollar amount of the transfer; 4) the reference code for the transfer; and 5) a description of the error or why I need additional information. You may also ask me to select a choice of remedy (credit to my account in an amount necessary to resolve the error or alternatively, a resend of the transfer in an amount necessary to resolve the error for those cases where bank error is found). Citibank will determine whether an error has occurred within ninety (90) days after I contact the bank. If Citibank determines that an error has occurred, Citibank will promptly correct that error in accordance with the error resolution procedures under the Electronic Fund Transfer Act and federal Regulation E or in accordance with the laws of the state where my account is located as may be applicable. In any event, any action or proceeding by me to enforce any obligation, duty or right under this Agreement must be commenced within one (1) year from the date that such cause of action accrues. IN NO EVENT SHALL CITIBANK BE RESPONSIBLE FOR ANY CONSEQUENTIAL, INCIDENTAL, SPECIAL, OR PUNITIVE DAMAGES OR EXPENSES IN CONNECTION WITH MY REMITTANCE TRANSFER. 16. CLAIMS WITH RESPECT TO ALL OTHER FUNDS TRANSFERS (INCLUDING REMITTANCE TRANSFERS SCHEDULED BEFORE OCTOBER 28, 2013) I agree that within thirty (30) days after I receive notification in my periodic account statement that the funds transfer request has been executed, I will notify Citibank of any errors, delays, or if I need additional information related to that funds transfer. If my funds transfer request was delayed or erroneously executed as a result of erroneous information provided by me, I understand that I may be responsible for the amount of that transfer and any associated fees. If my funds transfer request was erroneously executed or delayed as a result of Citibank s error, Citibank s sole obligation to me is to pay or refund such amounts as may be required under the Uniform Commercial Code Article 4A or by other applicable law. Any claim for interest payable by Citibank shall be at Citibank s published savings account rate in effect within the state of the home branch for the account from which the funds transfer was made. In any event, an action or proceeding by me to enforce any obligation, duty or right under this Agreement must be commenced within one (1) year from the date that such cause of action accrues. IN NO EVENT SHALL CITIBANK BE RESPONSIBLE FOR CONSEQUENTIAL, INCIDENTAL, SPECIAL, OR PUNITIVE DAMAGES OR EXPENSES IN CONNECTION WITH MY FUNDS TRANSFER, INCLUDING A REMITTANCE TRANSFER. AHSTINST 11/13 3

6 17. NOTICES Except as otherwise provided in this agreement, any notice given under this agreement shall be deemed given upon receipt of United States mail, postage prepaid, or by fax if delivered to me at the address and number shown in Citibank s account records to Citibank at the home branch where I opened my account or to which my account was assigned. I agree to promptly notify Citibank in writing of any changes to the information provided by me in this Agreement, including any schedules thereto. 18. AMENDMENT /TERMINATION Unless otherwise required by law, Citibank may amend the terms and conditions of this agreement without prior notice to me. If you choose to notify me of an amendment or are required to do so, you may mail or deliver a notice to me at the last address you have on file for me. This agreement may be terminated by either party at any time by written notice effective on the actual delivery date. 19. SEVERABILITY If any portion of this agreement is found to be unenforceable, its remaining portions shall remain in full force and effect. 20. GOVERNING LAW In general, this Agreement shall be governed by federal law and, where not in conflict with or preempted by federal law, the laws of the state in which my home branch is located. Funds transfers authorized under this Agreement may involve one or more funds transfer systems, such as Fedwire or the Clearing House Interbank Payments Systems (CHIPS). In these cases, the rules of the appropriate funds transfer system(s) will apply along with applicable law. Subpart B of Regulation J and Article 4A of the Uniform Commercial Code apply to funds transfers made through Fedwire. Funds transfers made through CHIPS are governed by and subject to CHIPS Rules and Administrative Procedures and the laws of the State of New York, including Article 4A of the Uniform Commercial Code. 21. ENTIRE AGREEMENT This Agreement, the Instruction, and all other schedules to this Agreement constitute the entire agreement between the parties relating to the subject matter of such documents, and supersedes any prior understanding or agreements by or between the parties, written or oral, related to such subject matter. is a service unit of Citibank, N.A. serving Citigold Private Client, Citigold International and Global Executive Banking clients at Citibank, N.A. Banking products and services are provided by Citibank, N.A., Member FDIC Citibank, N.A. Member FDIC Citi with Arc Design is a service mark of Citigroup Inc. or Citibank N.A., used and registered throughout the world. AHSTINST 11/13 4

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