The image is a scanned form for an account holder title, showing the name Erika Kellerhals and the date 2/10/15. The document is marked as confidential and contains reference numbers.
Type: form
Date: 2/10/15
Key Points:
Full Transcription:
CONFIDENTIAL - PURSUANT TO FED. R. CONFIDENTIAL SDNY_GM_00053546 EFTA_00164127 DB-SDNY-0016370 ButterDiy Trust Account Holder Title Individual ITF/POD/ATF Corporate Joint, with Rights Joint, Tenants Partnership of Survivorship Common Signature Signature Signature Limited Liability Corporation Other: Trust Account Number Number of Signatures Required: ERIKA KELLERHALS Print Name Print Name Print Name Print Name 2/10/15 Signature Approved Power of Attorney Specimen Signature * For TF/POD/ATF See Supplemental Terms and Conditions Date of Power of Attorney 13-AWM-0359 006678 080913
Significance: The document appears to be a form for an account holder title.
The image is a scanned document, specifically a form related to an account holder title. The document is oriented vertically and appears to be a standard form with various fields for information. At the top, the handwritten text "ButterDiy Trust" is visible. Below this, there are checkboxes for different account holder titles such as "Individual," "ITF/POD/ATF," "Corporate," "Joint, with Rights of Survivorship," "Joint, Tenants in Common," and "Partnership." The "Other" checkbox is selected, with the handwritten word "Trust" next to it. There are lines for signatures and printed names, with the name "ERIKA KELLERHALS" written in one of the print name fields. A date, "2/10/15," is handwritten in the "Date of Power of Attorney" field. A blacked-out area is present at the top right of the document. The bottom of the document contains additional printed text and numbers, including "13-AWM-0359" and "006678 080913." The words "CONFIDENTIAL - PURSUANT TO FED. R." are printed at the bottom left, and the word "CONFIDENTIAL" is printed in red. Document IDs are also printed at the bottom right. The image quality is medium, with some slight blurring. The document appears to be a legal or financial form.