Form 1

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“AGENCY (POWER OF ATTORNEY) DESIGNATION Agents may make account transactions for parties but have no owner- ship or rights at death unless named as POD beneficiaries. [To Add Agency Designation To Account, Name One Or More Agents]

[Select One and Initial]: AGENCY DESIGNATION SURVIVES DISABILITY OR INCAPACITY OF PARTIES AGENCY DESIGNATION TERMINATES ON DISABILITY OR INCAPACITY OF PARTIES”

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