9-3-2016

Exchange Funds Distribution Form

Date of Execution at Exchange Center ______, 2016

Exchange Center Location ______

Initial Questions:

Will my currencies be verified here on site today? ______

Will my initial exchange funds be available at the end of todays exchange process? ______

Will a structured payout plan be required for a portion of the currency being exchanged? ______Yes ______No

If yes, what amount of the funds will go into the structured payout plan?

$ ______

If Yes, over how many years will the structured payout plan be required? ______Years

If Yes, will the structured payout plan be interest bearing?

____ Yes, _____ No

If the Structured payout plan is interest bearing the annual interest rate will be ______%

We have read that Wells Fargo, or its exchange center designate will offer a temporary holding trust or similar vehicle, at the time of our exchange, to place the initial available funds into. This temporary structure, as we understand it, would be for our immediate use of the funds, while the expert legal help is arranged in setting up new suitable structures for humanitarian and personal use.

If a temporary holding trust is available then here are some things we will need to know.

1) What is a holding trust?

2) Who will be the trustees during that time?

3) When it comes time to transfer all the assets into a new trust and/or other structure, will it involve any issue we need to be aware of? Unless we misunderstand we have heard that you cannot change a irrevocable trust or simply transfer all your assets to another trust. So we would assume that the temporary trust would not have any such limitations.

If a temporary holding trust meets our needs, than we would like to place the appropriate exchange funds into that temporary trust.

How long will we have to get our permanent trusts and/or other structures in place before we are required to transfer funds to them? ______

If a temporary holding trust is not available, then we will place the initial available exchange funds into the existing accounts listed below:

These existing Wells Fargo (WF) accounts are:

1. A personal Bank account. Account # XXXXXX. Note this account to be re-designated as an interest bearing savings account.

2. A trust named "XXXXX XXXX Trust" Account # XXXXXX

Today we want to place XXXXXX (example 10 million) dollars, $ XXXXXXXX of the initially available exchange funds into the personal account.

Account # XXXXXXXX

In addition, if a temporary holding trust is not available, then all other initially available exchange funds, in the amount of ______$______will be placed in the "XXXXX XXXXX Trust" Account # XXXXXXX. Or what ever other structure a person has setup previously to receive these funds.