Exhibit 137 — USA v. Crowther (Dkt. 136.115)

Summary

Bank signature card form marked EX_137_001, Exhibit 137 as Document 136-115 in Case 2:20-cr-00114, headed IMPORTANT ACCOUNT OPENING INFORMATION. It names Margaret Crowther with the relationship Authorized Signer and an employer printed as Foundation For Lee County Public Schools. Page 2 lists the type of entity as Sole Proprietorship, the state or country as FL/USA, and an account description beginning Small Business, followed by taxpayer identification, backup withholding and exempt recipient statements made under penalties of perjury.

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Case 2:20-cr-00114-JES-M_M Document 136-115

Filed 03/31/21 - Page 1 of 2 PagelD

223327
Account Agreement Date: ___ 01/23/2014
Institution Name & Addtess Internal Use

Account Title & Address
FineMark National Bank and Trust
12681 Creekside Lane
Fort Myers, FL 33919 3950 Willlamson Rd

Fort Myers FL 33905

IMPORTANT ACCOUNT OPENING INFORMATION: Federal law r
us to obtain sufficient information to verify your identity. You may

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. Thare is additional

Owner/Signer Information space on page 2.

Ownership of Accetini
The specified ownership will remain the same for all accounts.
(For consumer accounts, select and initial.)

| Single-Party Account 0 Multiple-Party Account
ma Multiple-Party Account - Tenancy by the Entireties
Oo Corporation - For Profit Ol Corporation - Nonprofit

C1 Partnership Sole Propristorship [1] Limited Liability Company
oO Trust-Separate Agreament Dated:

Owner Signer Information 7 oO
Name Margaret Crowther
Relationship Authorized Signer (Check appropriate ownership above - select and initial below.)
Address 3950 Willlamson Rd C1 Singte-Party Account eet
Fort Myers, FL 33905 oO Single-Party Account with Pay-On-Death (POD)
Maliog a Oo Multiple-Party Account with Right of Survivorship
een Oo Multiple-Party Account with Right of Survivorship and POD
Home fone (239)848-5414 0) Muttipte-Party Account without Right of Survivorship
Work Phone (239)337-0433
Movie hone Beneficiary Namets!, Addresstes), and SSNis)
cue (Check appropriate beneficiary designation above.)
Birth Date 08/03/1985
SSN/TIN 590-70-1471
Gov't Issued Photo ID
Issue Date, Exp. Date) |On File
Other ID C1 if checked, this is a temporary account agreement.
(Description, Details) : ; . 1
Number of signatures required for withdrawal:
Employer Foundation For Lee County Public Schools
Previous
The undersigned authorize the financial institution to investigate credit
and employment history and obtain reports from consumer reporting
agency(ies) on them as individuals. Except as otherwise provided by law
Name or other documents, each of the undersigned is authorized to make
Relationship withdrawals from the account(s), provided the required number of
signatures indicated above is satisfied. The undersigned personally and
Address as, or on behalf of, the account owner(s) agree to the terms of, and
acknowledge receipt of copy(ies) of, this document and the following:
Mailog Address BJ Terms and Conditions Privacy
Ch cterent Ed Electronic Fund Transfers Truth in Savings
Home hone K] Substitute Checks Funds Availability
Worl Phone EJ Common Features oO
Mobile Phone
E-Mail Oo Convenience Account Agent (See Owner/Signer Information for
Convenience Account Agent desjgnation(s).)
Birth Date
SSN/TIN
Gov't Issued Photo ID ]
(Type, , State,
Issue Date, Exp. Date)
Other ID ]
(Description, Details)
= [ 1
Previous
L Financial inst. x x
Signature Card-FL MPMP-LAZ-FL_ 5/2/2007

Wolters Kluwer Financial Services _ 2003, 2006

Page 1 of 2
Initials:

EX_137_001
Case 2:20-cr-00114-JES-M_M Document 136-115 Filed 03/31/21 Page 2 of 2 PagelD

Owner Signer Information 3

Name Name Crowther Horses
Relationship EIN
ne Phone (239)848-5414
Mobile Phone
Mailing Address Eee
(if different) Type of Entity Sole Proprietorship
asome hope State/Country & Date |FL/ USA
Work Phone of Organization 1/7/2014
Mobile Phone Nature of
E-Mail iness
Birth Date 3950 Willlamson Rd
Address
SSN/TIN Fort Myers, FL 33905
Gov't Issued Photo ID oa
Nu 2 . Mailing Address
Other ID i
Authorization/
(Description, Details) Resolution Date
Employer Previous
Previous Financial Inst.

>

Account Description | Account # Initial Deposit Source

Name $

Relationship C1 cesh 1 check

Aderens Small Business Checkin) 5935378794 |

Mailing Address $

(if different) (O cash O10 check
as!

Home Phone

Work Phone

Mobile Phone $

EMail DD cash O10 check

Birth Date 0

SSN/TIN

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

ATM Debit/Check Cards (No. Requested:

Other ID

(De Details) Oo
iption, Detai
scription ails) oO o
Employer

(If not a "U.S. Person," certify foreign status separately.)
TIN: 590-70-1471

4] Taxpayer |.D, Number (TIN) - The number shown above is my
correct taxpayer identification number.

3] Backup Withholding - | am not subject to backup withholding
either because | have not been notified that | am subject to backup
withholding 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.

0 Exempt Recipients - | am an exempt recipient under the Internal
Revenue Service Regulations.

| certify under penalties of perjury the statements checked In
this section and that | am 3,U.S. person (including a U.S.

resident alien). jE < /4

AV ou dak (Date)

rgaret Crowthax.
Signature Card-FL MPMP-LAZ-FL §/2/2007
Benkers Systems *
Wolters Kluwer Financial Services . 2003, 2008 Initials: Page 2 of 2


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