Exhibit 135 — USA v. Crowther (Dkt. 136.113)

Summary

Two-page bank account opening form, marked EX_135_001 and EX_135_002, Exhibit 135 as Document 136-113 in Case 2:20-cr-00114, headed IMPORTANT ACCOUNT OPENING INFORMATION. The owner and signer entries name Margaret A Crowther and Casey D Crowther, each with the relationship Entireties, and the account title lists both names. The ownership choices on the form include Multiple-Party Account - Tenancy by the Entireties. Page 2 lists a Personal Checking account and a taxpayer identification and backup withholding certification made under penalties of perjury.

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Case 2:20-cr-00114-JES-M_M Document 136-113

2795

Filed 03/31/21 Page 1 of 2 PagelD

Account Agreement

FineMark National Bank and Trust
600 - 5th Avenue S

Suite 202

Naples, FL 34102

IMPORTANT ACCOUNT OPENING INFORMATION: Federal law requires
us to obtain sufficient information to verify your identity. You may be
asked several questions and to provide one or more forms of
identification to fulfill this requirement. In some instances we may use
outside sources to confirm the information. The information you provide
is protected by our privacy policy and federal law.

Enter Non-Individual Owner Information on page 2. There is additional
Owner/Signer Information space on page 2.

Owner/Signer Information 1

Name Margaret A Crowther

Relationship Entireties

Address 3950 Williamson Rd
Fort Myers, FL 33905

Mailing

(it different)

Home Phone (239)848-5414

Work Phone (239)337-0433

Mobile Phone

E-Mail

Birth Date 08/03/1985

SSN/TIN 590-70-1471

Gov't Issued Photo ID
(Type, Number, State,
Issue Date, Exp. Date)

C636-561-85-783-0
On File

08/08/2013

Internal Use
Account Title & Address
Margaret A Crowther

Casey D Crowther

3950 Williamson Rd
Fort Myers FL 33905

O O O
The specified ownership will remain the same for all accounts.

(For consumer accounts, select and initial.)

0 Single-Party Account | Multiple-Party Account
Multiple-Party Account - Tenancy by the Entireties

O Corporation - For Profit oO Corporation - Nonprofit

Oo Partnership [J Sole Proprietorship D Limited Liability Company
Oo Trust-Separate Agreement Dated:

(Check appropriate ownership above - select and initial below.)
Oo Single-Party Account

oO Single-Party Account with Pay-On-Death (POD)
Multiple-Party Account with Right of Survivorship

oO Multiple-Party Account with Right of Survivorship and POD
oO Multiple-Party Account without Right of Survivorship

Beneficiary Name(s), Address(es), and SSN{s}
(Check appropriate beneficiary designation above.)

Other ID - CO if checked, this is a temporary account agreemont.
(Description, Details) ‘ * ‘ 1
Number of signatures required for withdrawal:
Employer
The undersigned authorize the financial institution to investigate credit
O orma and employment history and obtain reports from consumer reporting
agency(ies) on them as individuals. Except as otherwise provided by law
Neme Casey D Crowther or other documents, each of the undersigned is authorized to make
Relationship Entiretles withdrawals from the account(s), provided the required number of
signatures indicated above is satisfied. The undersigned personally and
Address 3950 Willlamson Rd as, or on behalf of, the account owner(s) agree to the terms of, and
Fort Myers, FL 33905 acknowledge receipt of copy(ies) of, this document and the following:
Mailing Address Terms and Conditions Privacy
{it different) Electronic Fund Transfers Truth in Savings
Home Phone (239)872-7467 Substitute Checks KK] Funds Availability
Work Phone (239)872-7467 kK] Common Features oO
Mobile Phone
E-Mail O convenience Account Agent (See Owner/Signer Information for
— Convenience Account Agent designation(s}.)
Birth Date 09/02/1985 |
SSN/TIN 593-88-8937 if my ]
Gov't Issued Photo ID 04-8: x
(Type. Number, State, 636-1 5322-0 Ma are her
Issue Date, Exp. Date) |On File
Other ID | [ x ]
(Description, Details) : wther |
Employer Crowther Roofing |
Previous 3[ Xx ] al x ]
Financial Inst.
Signature Card-FL MPMP-LAZ-FL_ 5/2/2007

Bankers Systems #

Wolters Kiuwer Financial Services _ 2003. 2006

Page 1 01 2

EX_135_001
~case 2:20-cr-00114-JES-M_M -Doeument436-113- Filed-03/31/21 —Page 2 of 2 PagelD

2196

EIN

Phone

E-Mail

Type of Entity

State/Country & Date
of Organization

Resolution Date

Personal Checking

7210624732

Maling Address
Gf different)

Home Phone

Work Phona

0

lf not a °U.S. Person," certify foreign status separately.)
TIN: §80-70-1471

5] Taxpayer 1.D. Number (TIN) - The number shown above is my
correct taxpayer identification number.
Backup Withholding - | am not subject to backup withholding

either because | have npt-been notified that | em subject to backup
as a result of a failure to report all interest or dividends,

or the Internal Revenue Service has notified me that | am no longer

subject to backup withholding.

Oo Exempt Recipients - | am an exempt recipient under the Internal

Revenue Service Regulations.

1 certify under penalties of perjury the statements checked in

this section and that | am aU.S. person (including a Y.S.

Other

re
x 3| | 4 i
J
EX_135_002


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gov.uscourts.flmd.381779.136.113.pdf

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429,205 bytes

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33488b555cd2b88d6fc113f9f5a5b38e627308e5b5c416f57c0dbb00eaa3cfe5

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gov.uscourts.flmd.381779.136.113.pdf

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