UBS

UBS Financial Services Inc.

Account Number Y123692

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to multiple accounts

# Letter of Authorization for Duplicate Recipient of Tax Records

This letter authorizes UBS Financial Services Inc to send a copy of your tax form for the below accounts; to the following interested party(ies)
Such authorization with continue for ten years unless terminated by UBS Financial Services Inc or until you notify UBS Financial Services inc
writing of your decision to terminate the mailing of your tax reports to the parties below

in

Be advised that the service only pertains to your form 1099, 1099R or 10990 if you are eligible to receive a different tax report, this will not be sent to the below parties Also be aware that if you are a beneficiary on an account or a participant of a qualified plan, you are not eligible to enroll the account to send duplicate tax information to a third party

Interested Party Information (may select up to four)

INTERESTED PARTY

First Name: Alan
Middle Name: <empty>
Last Name: Blecher
Address Line 1: 685 Third Avenue
Address Line 2: <empty>
City: New York
State: NY
Zip: 10017
Email Address: Ablecher@markspaneth.com
Phone: 2122013197
Account Owner first Name: Ghislaine
Last Name: Maxwell
Account Owner Signature: <signature>
Date: 2-12-16

# Letter of Authorization for Duplicate Recipient of Tax Records (cont.)

0159495149



At-DP! Rev 10/11:

C2011 UBS Financial Services Inc All rights reserved Member SIPC.

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