Global Executive Banking GUARANTEED EXCHANGE RATE INSTRUCTIONS To ensure accuracy, please print all information clearly. Please complete required information on Sections I to III, and sign and date these Instructions on Section IV. If you require assistance in completing this form, please call Global Executive Banking CitiPhone Banking at (813) 604-3038 or 1 (866) 637-9041 (toll free within the U.S.). These Guaranteed Exchange Rate Instructions will be valid only if you have previously signed and delivered to us a Guaranteed Exchange Rate Funds Transfer Agreement for Consumer Accounts. I. Originator information Originator (Client s) name: Employer Name: Account number: Type (check one): n Checking n Savings* n Money market* *Limits on transfers apply, please refer to Client Manual - Consumer Accounts for more information. II. Transfer Information Please effect Guaranteed Exchange Rate (GER) transfers monthly for the account listed above as follows: Start GER transfers on the next available GER transfer date after / / (mm/dd/yyyy) Your GER transfer will continue until you or your employer advises us to cancel it. Dates of GER transfers are defined by the employer. Only available if your employer participates in this service and confirms your eligibility. Please check with your Human Resources department for more information. Exchange rate is set by your employer periodically. III. Wire Transfer: Required information Remittance Amount in US Dollars Currency in which Beneficiary account is maintained* Amount (please write amount in words) Beneficiary Bank Name Beneficiary Bank Address ABA/SWIFT/ Bank Identifier Code (BIC) City Sort Code/GBP currency Country Beneficiary Name Beneficiary Phone#** For Further Credit (if applicable) Beneficiary name Intermediary Bank Bank Name ABA / SWIFT / Bank Identifier Code (BIC) Information (if applicable) Bank Address Special instructions *The GER will be delivered in this currency **Required for Chinese and Korean currency transfers IV. Authorizations By signing below, I acknowledge that this Guaranteed Exchange Rate Instructions shall be processed pursuant to the terms and conditions of my Guaranteed Exchange Rate Funds Transfer Agreement for Consumer Accounts. Originator s (client) signature / / Date (mm/dd/yyyy) Global Executive Banking is a service of Citibank N.A., providing banking and borrowing products and services. GEB GERINS 0314 2013 Citigroup Inc. Citi with Arc Design is a service mark of Citigroup Inc. or Citibank, N.A., used and registered throughout the world.
Guaranteed Exchange Rate Funds Transfer Agreement for Consumer Accounts Client Name: Employer Name: This Guaranteed Exchange Rate Funds Transfer Agreement for Consumer Accounts (hereafter referred to as Agreement, sets forth the terms and conditions under which the Client identified above (hereafter referred to as I, me, or my ) instructs Citibank, N.A. (hereafter referred to as Citibank, we, or our ) to transfer funds on a recurring basis from the account identified in the attached Guaranteed Exchange Rate Instructions Page (hereafter referred to as Instructions Page ) to another account with Citibank or with another financial institution, at a foreign exchange rate provided by my employer ( Guaranteed Exchange Rate Transfer or GER Transfer ). I understand and acknowledge that my employer (identified above) is enrolled in a Guaranteed Exchange Rate Program through Global Executive Banking at Citibank, and that this Agreement governs all GER Transfers requested by me under my employer s Guaranteed Exchange Rate Program. Instructions regarding any other funds transfers shall not governed by this agreement, and will be subject to the terms and conditions of the corresponding Citibank account and applicable funds transfer service. Certain Guaranteed Exchange Rate Transfers governed by this Agreement are Remittance Transfers (as defined below) and are governed by federal law as of October 28, 2013. A Remittance Transfer is an electronic transfer of funds initiated from a consumer account located in the United States primarily for personal, family or household purposes to a designated recipient (hereafter referred to as beneficiary ) located outside the United States. For each Remittance Transfer that I initiate, Citibank will provide me with certain disclosures required by federal law at the time I initiate the transfer. To the extent the provisions of this Agreement are inconsistent with the disclosures provided to me for a Remittance Transfer, the provisions of such disclosures shall govern. As used in this Agreement, the term business day means any day that is not a Saturday, Sunday, or bank holiday. 1. AUTHORITY TO TRANSFER FUNDS I authorize Citibank to execute and charge to my account any valid GER Transfer request made on the attached Instructions Page, provided such Instructions Page is duly completed and executed by an authorized signer of the account in accordance with the procedures established by Citibank. I understand and acknowledge that Citibank has no obligation to execute any GER Transfer request that is not initiated in accordance with such procedures. This authorization applies to the account identified on the Instructions Page. I further authorize Citibank to charge such account for any applicable service fees for funds transfers in accordance with the disclosures I receive as required by Federal Law in connection with this Agreement. I understand and acknowledge that no GER Transfer may be scheduled for a date that is less than fifteen (15) business days after the date of this Agreement and the Instructions Page. 2. FUNDS TRANSFER REQUESTS I understand that to authorize a GER Transfer, I must complete and send an original signed copy of the Agreement and the Instructions Page to the Customer Service Center at: If by mail: If by courier: Citibank N.A. Citibank, N.A. GEB Customer Service Center GEB Customer Service Center P.O Box 31277 3800 Citigroup Center, Building A1-03 Tampa, FL 33631-3277 Tampa, Florida 33610 U.S.A. U.S.A. 3. SECURITY PROCEDURES For Remittance Transfers, Citibank personnel will perform a call back to an authorized signer of the applicable account at the telephone numbers registered with Citibank to provide certain disclosures required by regulation. For all funds transfer requests including Remittance Transfers, Citibank may perform a call back to an authorized signer to verify the request. In the case of an amendment to an Instruction Page, I will also be required to provide Citibank with a written and signed Instruction from an authorized signer of the account. I agree that Citibank will not be liable for any delay in processing my GER Transfer request resulting from compliance with these security procedures. I agree that the use of these security procedures to verify that my instructions have been properly authorized is commercially reasonable for me. I further understand that the security procedure is designed to verify the source of the request and not to detect errors in the content of my instruction. I further agree to notify Citibank of any changes to the information provided by me in this agreement, the Instructions Page or any other schedule hereto, in accordance with Section 13 of this Agreement. Any such notice must be in writing and sent to the Customer Service Center address listed in Section 2 of this Agreement. GEB GERAGR EE01013 1
4. INFORMATION SUPPLIED BY CLIENT I agree that Citibank will rely on the information I have provided in making the GER Transfer. I understand that it is my responsibility to provide Citibank with accurate information regarding that transfer, including the account number of the beneficiary of the GER Transfer (such as IBAN ) and where applicable, the number (such as BIC or SORT ) identifying the beneficiary institution, since payment will be processed based on the number(s) provided by me. Should I provide an incorrect account number and/or beneficiary bank identifier, I understand that any losses resulting from the funds being credited to the wrong account will be my responsibility. I will be required at the time I complete and sign the Instruction Page to provide Citibank with information regarding the currency in which the beneficiary account is maintained. I understand and acknowledge that Citibank will rely on this information in executing my instructions in accordance with the provisions set forth in the Section 11 of this Agreement. 5. EXECUTION OF A SCHEDULED OR RECURRING FUTURE-DATED FUNDS TRANSFER REQUEST If the date of a scheduled or recurring future- dated GER Transfer request falls on a day that is not a business day, I understand that my request will be executed on the next business day. Citibank will make the determination to pay or reject my GER Transfer request on the day on which it is executed based on my available balance at the time the GER Transfer request is processed. 6. REJECTION OF FUNDS TRANSFER REQUEST Citibank reserves the right to reject my request for a GER Transfer if I have insufficient available funds in my account, if my instruction is received by Citibank by a communication means not authorized by the bank, if my instruction is unclear or incomplete, if Citibank is unable to verify my GER Transfer request, if Citibank is unable to reach me and provide any of the disclosures that, beginning October 28, 3012, federal law requires be delivered to me prior to Citibank executing a Remittance Transfer, or if for any reason the request is unsatisfactory to Citibank. 7. RESPONSIBILITY FOR FUNDS TRANSFERS To the fullest extent permitted by law, I agree to assume full responsibility and be bound by all GER Transfer requests issued in my name, whether or not authorized, provided the GER Transfer request was executed by Citibank in good faith and in accordance with the procedures set forth in this agreement. 8. DELAYS, NON-EXECUTION OF FUNDS TRANSFER REQUESTS While Citibank will handle my GER Transfer request as expeditiously as possible, I agree that, to the fullest extent permitted by law, Citibank will not be responsible for any delay or failure to execute my GER Transfer request, or delay in making the funds available to the beneficiary due to circumstances beyond the control of Citibank or any intermediary or beneficiary bank handling the transfer, including, without limitation, any inaccuracy, interruption, delay in transmission, or failure in the means of transmission of my GER Transfer request to the bank or execution of such request by the bank, whether caused by strikes, power failures, equipment malfunctions, or delays caused by one or more institution s fraud screening procedures or compliance procedures for anti-money laundering, economic sanctions or similar laws. I further agree that you may refuse to process or delay processing any request if it would violate any guideline, rule, policy, or regulation of any government authority or funds transfer system. TO THE EXTENT PERMITTED BY LAW, CITIBANK MAKES NO WARRANTIES, EXPRESS OR IMPLIED, WITH RESPECT TO ANY MATTER IN CONNECTION WITH MY FUNDS TRANSFER. 9. INDEMNITY In consideration of the agreement by Citibank to act upon funds transfer requests in the manner provided in this Agreement, I agree to the fullest extent permitted by applicable law to indemnify and hold Citibank harmless from and against any and all claims, suits, judgments, execution, liabilities, losses, damages, costs, and expenses-including reasonable attorney s fees - in connection with funds transfers made pursuant to this Agreement. This indemnity will not be effective to relieve and indemnify Citibank against its gross negligence, bad faith, willful misconduct, or as otherwise provided by law. 10. DESIGNATION OF BENEFICIARY BANK FOR EXTERNAL FUNDS TRANSFERS In order to instruct Citibank to execute an external GER Transfer, I must specify a financial institution ( beneficiary bank ) to receive it in Section III of the Instruction Page. I may request the beneficiary bank to credit an account or to hold the funds for the beneficiary. In either case, the beneficiary bank is responsible for following my instructions and notifying the beneficiary when the funds become available. If I identify a beneficiary by name and account number, the beneficiary bank may pay the funds to the person identified by the account number and my payment may be final even if the account number provided by me does not correspond to the beneficiary. (The beneficiary bank is not obligated to verify that the account number belongs to my beneficiary.) If the beneficiary bank is unable to locate an account, the funds may be returned. Except as may be prohibited by applicable federal law for Remittance Transfers, any losses resulting from any incorrect information I provide regarding my beneficiary are my responsibility. 11. CURRENCY OF TRANSFER I will specify the currency in which the beneficiary account is maintained in Section III of the Instruction Page. I understand that Citibank will rely on such currency information to execute my GER Transfer, and will provide me with information about the transfer based on the currency I have indicated. Citibank will convert my U.S. dollar payment to the currency I have indicated at the guaranteed exchange rate specified by my employer. GEB GERAGR EE01013 2
12. MEANS OF TRANSFER To make external GER transfers, Citibank uses a variety of banking channels and facilities but will ordinarily use electronic means. I agree that Citibank may choose any conventional means that Citibank deems suitable to transfer my funds to the beneficiary. Because Citibank does not maintain banking relations with every bank, it may be necessary to use one or more intermediary banks before the funds are transferred to the beneficiary bank. After Citibank transmits the funds transfer to the intermediary bank, it will be that bank s responsibility to ensure that the funds transfer is completed. I understand that there may be fees imposed by these other banks for handling my funds transfer and that these fees may be deducted from the transfer amount before it is credited to the beneficiary. Beginning October 28, 2013, federal law requires Citibank to disclose applicable fees prior to executing the (a) first Remittance Transfer in a series of recurring transfers, and (b) subsequent Remittance Transfers in such series if there has been a change to the fees, exchange rate, or amount transferred. 13. CANCELLATION OR AMENDMENT OF GER TRANSFERS GER Transfers may only be scheduled for dates that are no less than fifteen (15) business days following the date of this Agreement and the Instructions Page. On or after October 28, 2013, I have the right to cancel a GER Transfer by notifying Citibank three (3) business days prior to the date of the scheduled transfer. When I notify Citibank, I will provide my name and address or telephone number and identify the particular transfer to be cancelled. I understand that I may request the cancellation of a scheduled transfer by calling 1-813-604-3038, or 1-866-637-9041 (toll-free within the U.S. (TTY 1-800-945-0258) or by sending a written communication to the Customer Service Center at the address set forth in Section 2. Effective October 28, 2013, for Remittance Transfers, my cancellation rights will be defined in the disclosures provided to me in accordance with federal law. To change or amend existing GER Transfer instructions (other than for purposes of cancelling a transfer), I agree that I must provide Citibank with notice of the requested change fifteen (15) business days prior to the scheduled transfer date. If I notify Citibank that I wish to amend existing GER Transfer instructions within fifteen (15) business days of a scheduled transfer, I understand that the amendment to the instructions will not take effect until the subsequent scheduled transfer. (For example, if GER Transfers are scheduled for October 15 and November 15, and I request a change to my GER Transfer instructions on October 10, the requested change will not take effect until November 15.) If I do not comply with the timing obligations set forth in this section, I understand and agree that the request to cancel or amend the GER Transfer may still be effective with the voluntary consent of Citibank and the beneficiary bank. Citibank will first have to check with the beneficiary bank to determine whether or not the beneficiary bank will return my funds. If the beneficiary bank confirms that the funds are returnable and the funds are returned to Citibank, Citibank will return the funds to me. The amount that is returned to me may be less than I originally transferred because of service charges of the beneficiary bank and/or Citibank. My returned funds will be converted to U.S. dollars at the exchange rate established by Citibank on the date of return. Citibank shall not be liable to me for any loss resulting from the failure of the beneficiary bank to accept a cancellation or amendment of my GER Transfer request. 14. CLAIMS WITH RESPECT TO REMITTANCE TRANSFERS MADE ON OR AFTER OCTOBER 28, 2013 If I believe there has been an error or I need more information about my GER Transfer, I agree that I must contact Citibank within one hundred and eighty (180) days of the date indicated by Citibank that the funds would be available to the beneficiary of that transfer. I understand that I may contact Citibank at 1-813-604-3038, 1-866-637-9041, (TTY 1-800-945-0258) or by mail at the address set forth in Section 2. At that time, I may be asked to provide the following information: 1) my name, address and account number; 2) the name of the person receiving the funds, and if I know it, his or her telephone number or address; 3) the dollar amount of the transfer; 4) the reference code for the transfer; and 5) a description of the error or why I need additional information. You may also ask me to select a choice of remedy (credit to my account in an amount necessary to resolve the error or alternatively, a resend of the transfer in an amount necessary to resolve the error for those cases where bank error is found). Citibank will determine whether an error has occurred within ninety (90) days after I contact the bank. If Citibank determines that an error has occurred, Citibank will promptly correct that error in accordance with the error resolution procedures under the Electronic Fund Transfer Act and federal Regulation E or in accordance with the laws of the state where my account is located as may be applicable. In any event, any action or proceeding by me to enforce any obligation, duty or right under this Agreement must be commenced within one (1) year from the date that such cause of action accrues. IN NO EVENT SHALL CITIBANK BE RESPONSIBLE FOR ANY CONSEQUENTIAL, INCIDENTAL, SPECIAL, OR PUNITIVE DAMAGES OR EXPENSES IN CONNECTION WITH MY REMITTANCE TRANSFER. 15. CLAIMS WITH RESPECT TO ALL OTHER FUNDS TRANSFERS (INCLUDING TRANSFERS SCHEDULED BEFORE OCTOBER 28, 2013) I agree that within thirty (30) days after I receive notification in my periodic account statement that the funds transfer request has been executed, I will notify Citibank of any errors, delays, or if I need additional information related to that funds transfer. I understand that I may contact Citibank at 1-813-604-3038, 1-866-637-9041, (TTY 1-800-945-0258) or by mail at the address set forth in Section 2. If my funds transfer request was delayed or erroneously executed as a result of erroneous information provided by me, I understand that I may be responsible for the amount of that transfer and any associated fees. If my funds transfer request was erroneously executed or delayed as a result of Citibank s error, Citibank s sole obligation to me is to pay or refund such amounts as may be required under the Uniform Commercial Code Article 4A or by other applicable law. Any claim for interest payable by Citibank shall be at Citibank s published savings account rate in effect within the state of the home branch for the account from which the funds transfer was made. In any event, an action or proceeding by me to enforce any obligation, duty or right under this Agreement must be commenced within one (1) year from the date that such cause of action accrues. IN NO EVENT SHALL CITIBANK BE RESPONSIBLE FOR CONSEQUENTIAL, INCIDENTAL, SPECIAL, OR PUNITIVE DAMAGES OR EXPENSES IN CONNECTION WITH MY FUNDS TRANSFER, INCLUDING A REMITTANCE TRANSFER. GEB GERAGR EE01013 3
16. NOTICES Except as otherwise provided in this agreement, and to the extent permitted by law, any notice given under this agreement shall be deemed given upon receipt of United States mail, postage prepaid, or by fax if delivered to me at the address and number shown in Citibank s account records to Citibank at the home branch where I opened my account or to which my account was assigned. I agree to promptly notify Citibank in writing of any changes to the information provided by me in this Agreement, including on the Instructions Page or any schedules thereto. 17. AMENDMENT /TERMINATION Unless otherwise required by law, Citibank may amend the terms and conditions of this agreement without prior notice to me. If you choose to notify me of an amendment or are required to do so, you may mail or deliver a notice to me at the last address you have on file for me. This Agreement shall terminate automatically upon termination of my employer s participation in a Guaranteed Exchange Rate Program through Global Executive Banking at Citibank. This Agreement may also be terminated by either party at any time by written notice effective on the actual delivery date. In addition, I understand and acknowledge that if my account with Citibank ceases to be part of a Citi Global Executive Preferred Account Package, for any reason whatsoever, whether because of my or Citibank s actions, Citibank may terminate or cancel, without prior notice, unless otherwise required by law, this Agreement and Instruction Page, and all scheduled GER Transfers will be rejected following such termination. 18. SEVERABILITY If any portion of this Agreement is found to be unenforceable, its remaining portions shall remain in full force and effect. 19. GOVERNING LAW In general, this Agreement shall be governed by federal law and, where not in conflict with or preempted by federal law, the laws of the state in which my home branch is located. Funds transfers authorized under this Agreement may involve one or more funds transfer systems, such as Fedwire or the Clearing House Interbank Payments Systems (CHIPS). In these cases, the rules of the appropriate funds transfer system(s) will apply along with applicable law. Funds transfers made through Fedwire are governed by and subject to the provisions of Subpart B of Regulation J and Article 4A of the Uniform Commercial Code, to the extent such provisions are not inconsistent with the provisions of Section 919 of the Electronic Fund Transfer Act. Remittance transfers made through CHIPS are governed by and subject to CHIPS Rules and Administrative Procedures and the laws of the State of New York, including Article 4A of the Uniform Commercial Code, except in the case of an inconsistency between New York law and the Electronic Fund Transfer Act, in which case the Electronic Fund Transfer Act shall govern. 20. ENTIRE AGREEMENT This Agreement, the Instruction Page, and all other schedules to this Agreement constitute the entire agreement between the parties relating to the subject matter of such documents, and supersedes any prior understanding or agreements by or between the parties, written or oral, related to such subject matter. 21. AGREEMENT TO TERMS AND CONDITIONS By signing below, I confirm that I have read and agreed to the terms and conditions stated in this Agreement on behalf of all Account Owners on the account identified in the attached Instructions Page. Name (Please Print) Signature Date (mm/dd/yyyy) Global Executive Banking is a service of Citibank N.A., providing banking and borrowing products and services. Customer Service Center is a service unit of Citibank, N.A. serving Global Executive Banking clients at Citibank, N.A. 2013 Citibank, N.A. Member FDIC Citi with Arc Design is a service mark of Citigroup Inc. or Citibank N.A., used and registered throughout the world. GEB GERAGR EE01013 4