EFTA00089338¶
Attorneys¶
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Jacqueline M. Hudkins Reema T. Maroun
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Morgan D. Jones
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Laura M. Tomasello
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Richard G. Anderson
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Martha L. Prizio John P. Rob Dennis P. Vachon* Candice M. O’Neil* Greg Racki*
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Admitted to Practice in NH & MA
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Admitted to Practice in VT & MA
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Admitted to Practice in MA & RI
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Admitted to Practice in NH & VT
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Admitted to Practice in NH
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Admitted to Practice in MA.
- Of course!
IF YOU ARE EXPECTING TO RECEIVE PROCEEDS AND WOULD LIKE YOUR PROCEEDS WIRED, PLEASE COMPLETE THIS FORM IN ITS ENTIRETY¶
PLEASE NOTE THAT A WIRE FEE OF $50.00 WILL APPLY¶
This form must be filled out in its entirety to ensure a timely wire. Hudkins Law is unable to transmit a wire unless all of the data fields on this form have been completed and verified.¶
Name of Wire recipient:___¶
Phone Number where you may be reached on the date of the expected wire:¶
| Name of Receiving Bank | |
| ABA Routing Number of Receiving Bank(9 digit number)*This may not be the routing number listed onthe bottom of your checks.Please call your bankto verify the number used to receiving anincoming wire* | |
| Address of Receiving Bank | Street:City/State/Zip: |
| Phone Number of Receiving Bank | |
| Account Number | |
| Name(s) on Your Account | |
| Address Associated with Your Account(Physical Address;not P.O.Box) | Street:City/State/Zip: |
| If Applicable,Provide Additional InstructionsHere.Example:“For Further Credit to”or“For the Benefit of” |
By signing this form, I hereby acknowledge that the information is correct and accurate and I agree to the wire fee of $50.00. I further agree to verify this information by telephone or in person on the date of the wire transmission.¶
I understand that the receiving bank may charge an incoming wire fee to my account.¶
Hudkins Law PLLC hereby reserves the right to initiate a “test” wire for a nominal amount to confirm the accuracy of these wiring instructions. I agree to cooperate with the verification of receipt of said “test” wire.¶
| Signature | Date | Signature | Date |
Internal Use Only:¶
___ Telephone Verification by___ Date/Time:___¶
___ In Person Verification by___ Date/Time:___¶