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OUTGOING WIRE FUNDS TRANSFER REQUEST

WIRE AMOUNT/SOURCE
SELECT ONE

AMOUNT TO WIRE *

WIRE DESTINATION/CURRENCY TYPE *

DOMESTIC WIRE (U.S. Dollars)


U.S.DOLLARS ONLY
INTERNATIONAL WIRE _______________________

REPETITIVE WIRE ID # *

NOTE: For Repetitive Wires, w here instructions are on file

Provide amount in the Currency Type indicated

Indicate Currency Type

FOREIGN CURRENCY EXCHANGE RATE SOURCE (If Applicable)


If OVER US $25,000 equivalent contact 1-(888) 819-8883 for a rate quote
Rat e Source:
RATE SHEET FX DESK

w ith Bank, complete ONLY those fields w ith an asterisk

ACCOUNT NUMBER / SOURCE OF FUNDS *

009891112-96568/10

W/D FROM ACCOUNT #: _______________________________

0.12%
06/12/15
FX Rat e: ______________________________________
Value Dat e_________________
I.R.O
Quot ed By: _________________________
USD Equivalent

CB8725452

US$ 12,500,000

CASH - Credit ed by Branch t o GL 242830/cc 510


(Prior Risk & Operations approval required if over branch limit)

21.00
$ : ____________________

CHECK - Credit ed by Branch t o GL 242830/cc 510

(Trader s Name)

Citib73656367/15
Ref erence #: ______________________________________________________________

(Prior Risk Management approval required if over branch limit)

ORIGINATOR INFORMATION *
ORIGINATORS NAME *

ORIGINATORS CONTACT PHONE NUMBER *

Mr. Raymond Mcguire

646-741-9904

WIRE TO

PAYMENT INSTRUCTIONS
CREDIT TO ACCOUNT NAME

RECEIVING BANKS NAME

Wells Fargo Bank, N.A.

qNETIQ Inc

RECEIVING BANKS ADDRESS

CREDIT TO ACCOUNT NUMBER

Turtle Creek Branch, 6093 US Hwy 98,


Hattiesburg, MS 39402-U.S.A

3574052951 (USD)
International Wires ONLY: check here ONLY if t his is a USD account
FURTHER CREDIT TO ACCOUNT NUMBER (If Applicable)

3574052951 (USD)
(If foreign bank address, please include both CITY and COUNTRY information.)

RECEIVING BANKS ABA (for domestic) or SWIFT Number (for international)

FURTHER CREDIT TO ACCOUNT NAME (If Applicable)

ABA Number: 062203751


SWIFT Code: WFBIUS6S

qNETIQ Inc

MESSAGE OR REFERENCE *

RECIPIENTS NAME, ADDRESS, PHONE NUMBER

Transfer is in favour of qNETIQ Inc,11 MacArthur


Blvd. - Suite 103EHaddon Twsp, New Jersey 08108
United States

qNETIQ Inc,11 MacArthur Blvd. - Suite 103E


Haddon Twsp, New Jersey 08108
United States

ORIGINATORS AUTHORIZATION *
By Signing below, I agree to the terms accompanying this form.*

(Originat or s Signat ure)

(Dat e)

(Originat or s Signat ure)

(Dat e)

BANK USE
ORIGINATORS ID and TIN INFORMATION*

REQUEST TYPE / CALLBACK RESULTS

Driver s License
Passport Green Card

In Person Letter (Attached) Phone* FAX *


E-Mail*

Ot her: ___________________________________
U.S.A Government
Issued By: _________________________________

Mr. Raymond Mcguire


No FTA Form - Approval By: _______________________________________
(Printed Name - approving Branch Manager or Risk & Operations Employee.)

Callback Completed w /Auth Customer No Callback (FTA Waiver)

450729975
Serial Number: ______________________________

qNETIQ Inc
Aut horized Cust omer s Name: _______________________________________

NIL
Tax ID Number: ____________________________

Citibank
Callback/FTA Verif ied By: ___________________________________________

* Phone / FAX / E-Mail Requests - 1.) MUST


adhere to Bank callback requirements; and 2.)
MUST have a Funds Transfer Designation and
Authorization (FTA) on file. If NO FTA is on
file, the request must be approved by the
Branch Manager (up to $200,000) OR Risk
& Operations (if over $200,000)!

FEE AMOUNT

12,500

$ _____________

(Printed Name & Initials employee w ho completed callback or verified FTA w aiver.)

BRANCH/DEPARTMENT USE ONLY


INSTRUCTIONS ACCEPTED BY (Printed Name & Signature)

Foreign Operations

JP Morganchase Bank,United States of America,


Date Accepted

Time Accepted

06/12/15

A.M.

P.M.

WIRE DEPARTMENT USE ONLY


Dept./Branch Name or #

Test Key Reference Number

Citi-CITIi8677678997

Test Key Result Number

TT/4247T7887943454

WIRED BY (Printed Name & Signature)

Mr. Raymond Mcguire


VERIFIED BY (Printed Name)

Mrs. Naggy Lopez

SUPERVISOR/AUTHORIZED EMPLOYEE APPROVAL (2nd signature required if over limit)

CALLBACK VERIFICATION BY (Printed Name)

(Verification of request form, cust. ID, payment method, request type and customer s authority as an authorized account signer.)

Mrs. Naggy Lopez

________________________________

_________________________________

Approval Signature

Over Limit Approval Signature (as required by policy)

__________________________________________

___________________________________________

Printed Name REQUIRED

Printed Name REQUIRED

WIRE2012.DOC / Rev. 09-2012

(Verified With Printed Name) DATE WIRE EXECUTED

Funds Transfer Terms


1.

Customer ( You ) authorize East West Bank ( us ) to make the funds transfer described on this form.

2.

You agree to hold us harmless from any loss w hich occurs if your instructions are incomplete, ambiguous or
incorrect. We are not required to seek clarification from anyone regarding ambiguous instructions. If w e
cannot complete a transfer (e.g., because of an ambiguity), w e w ill notify you orally or in w riting by the end
of the next business day.

3.

If you identify the Beneficiary, the Beneficiary Bank or an Intermediary Bank by name and number, payment of
the order may be made based on the number alone, even if it identifies a person or bank different from that
show n on the front of this form.

4.

We may transfer funds through an intermediary bank or funds transfer system w hich is different from that
show n in your instructions.

5.

If w e receive your payment order after our processing cutoff hour or on a Saturday, Sunday or holiday, w e
may process it on the next funds-transfer business day. A delay may also occur if an Intermediary Bank or
the Beneficiary s Bank is not accepting a payment order (e.g., due to a local holiday).

6.

You do not have a right to cancel or amend your order. You agree to hold us harmless from all claims and
damages, how ever, if w e attempt (successfully or otherw ise) to comply w ith your request. If your order
involves foreign exchange, and w e attempt to comply w ith your cancellation or amendment request, or if w e
do not send the transfer because insufficient funds are in your account, our damages may include losses due
to exchange rate fluctuations and other costs of canceling, amending or covering the order from any counter
party to the order.

7.

If your transfer is made from an account w ith us, it w ill be reflected on your next periodic statement. You
w ill not receive any other notice from us regarding your transfer. You agree to notify us immediately if you
notice any discrepancy betw een your statement and this payment order or you discover a problem w ith your
transfer. You must send us a w ritten notice of the problem, including a statement of the relevant facts,
w ithin a reasonable time (not to exceed 14 days from the date you first discover the problem or receive a
statement or notice reflecting the erroneous transfer, w hichever occurs first). Upon requesting a payment
order w e reserve the right, prior to debiting your account for the requested transfer, to place a hold on your
account for the amount of funds requested to be transferred.

8.

All foreign transfers w ill be sent in the foreign currency type indicated or, if no currency type w as provided, in
the currency type selected by us based on the country the funds are being delivered to. Foreign transfers may
be subject to delays, charges imposed by other banks and changes in foreign currency exchange rates and/or
currency type delivered to the beneficiary. You agree to and accept the foreign exchange rate (FX Rate)
indicated or otherw ise provided by us at the time the foreign transfer w as sent.

9.

We w ill not be liable for consequential, special or exemplary damages or losses of any kind. We w ill not be
liable for any failure to act or delay due to: a lack of sufficient available funds in your account; circumstances
beyond our reasonable control; fire, flood or natural disasters; communication failures; labor disputes; any
inaccuracy or ambiguity in your instructions; the action or inaction of others; or any applicable government or
funds-transfer system rule, policy or regulation.

WIRE2009-back.DOC / Rev. 8-2009