Consumer Account Application

Bank Name Bank Use Only

Wells Fargo Bank
Account(s) I want to Open Phone Bank/AU 2839 COID 114
8458133918 DDARC 09/14/2023 0da8acdd-52ba-49ed-abd3-aab963ec46c2
Purpose of Account Disclosure Delivery method

To help the government fight the funding of terrorism and money laundering activities, U.S. Federal law requires financial institutions to obtain, verify, and record information that
identifies each person (individuals and businesses) who opens an account. What this means for you: When you open an account, we will ask for your name, address, date of birth
and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.
Customer 1 Information Sole Owner Customer 2 Information
Full Name Full Name
JANE L HOGAN
Street Address How long at this address Street Address How long at this address
9802 BLOOMFIELD AVE APT 41 YR MO YR MO

Directional Address (Document directional address for customers who do not have Directional Address (Document directional address for customers who do not have
physical residence, business or alternate street address.) physical residence, business or alternate street address.)

City State Zip Code Cntry City State Zip Code Cntry
CYPRESS CA 90630-3407
Taxpayer Identification Number (TIN) Home Phone Taxpayer Identification Number (TIN) Home Phone
556921638
Previous Street Address How long at this address Previous Street Address How long at this address
YR MO YR MO

City State Zip Code Cntry City State Zip Code Cntry

Current Employer Business Telephone Number Current Employer Business Telephone Number

Primary ID Description Date of Birth Primary ID Description Date of Birth

08/15/1951
State / Country Issue Date Exp. Date State / Country Issue Date Exp. Date

Customer Number (ECN) Customer Number (ECN)

Request for Taxpayer Identification Number and Certification (Substitute Form W-9)
Certification: Under penalties of perjury, I certify that:
1) The number shown on this form is my correct Taxpayer Identification Number, and
2) UNLESS I HAVE CHECKED ONE OF THE BOXES BELOW, I am not subject to backup withholding either because I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or the IRS has notified me that I am no longer subject to
backup withholding (does not apply to real estate transactions, mortgage interest paid, the acquisition or abandonment of secured property, contributions to an Individual
Retirement Arrangement (IRA), and payments other than interest and dividends), and
3) I am a U.S. citizen or other U.S. person and
4) The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. (Does not apply to U.S. based accounts)
The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.
TIN Certification Signature Date
I am subject to backup withholding I am exempt from backup withholding X

Joint Account Right of Survivorship (Alabama, Tennessee and Texas Only)

The persons signing this section hereby agree with each other and the bank that this account is a joint account with right of survivorship, and that on the death of one party to a
joint account, all sums in the account on the date of death vest in and belong to the surviving party as his or her separate property and estate. Each person signing this section
who is married to a person who is not also signing this section represents and warrants that no funds now or hereafter deposited to the account, nor any interest earned on such
funds, are subject to the management, control or disposition (jointly or otherwise) of such person's spouse.
Customer 1 Signature Customer 2 Signature
X X

Signatures
Everything I have stated in this application is correct. You are authorized to make any inquiries that you consider appropriate to determine if you should open or maintain the
account. This may include ordering a credit report or other report (i.e. information from any motor vehicle department or other state agency) on me. I have received a copy of
the applicable account agreement and the privacy policy (as each may be amended from time to time) and agree to be bound by their terms. I also agree to the terms of the
dispute resolution program described in the foregoing agreements. Under the dispute resolution program, our disputes will be decided before one or more neutral
persons in an arbitration proceeding and not by a jury trial or a trial before a judge.
For account number(s) 8458133918 Types(s) TIN
DDARC 556921638
Customer 1 Authorized Signature Date JANE L HOGAN
X
Customer 2 Authorized Signature Date
X

DSG8921 (04.2015_PB ELM)