EFTA Document EFTA01269485

1 First Bank Existing Account Number r\ICF:r2t‘s-n-iS Customer Due Diligence For Additional Signers on Individual Accounts or Authorized Signatures on Business Entities Accounts Account Number. which Is attached to the Signer Ian iaauto 1 Authorized S:gncr hirommtion Name: Cecile ____ Initial: Lai,' h Am. de.c '3' Data of Birth: _ Place of Birth USA _ Citizenship I MF 'form Pinne _ _ _ _ Physical Address: Mai :-.a Amin... Place of Employment Southern Comny Id. Occupati