Exhibit 89 — USA v. Crowther (Dkt. 136.67)

Record facts

U.S. District Court for the Middle District of Florida · No. 2:20-cr-00114 · Doc. 136-67 · 2021-03-31 · Docket on CourtListener

Full text

2550
_____AGCOUNT AGREEMENT —
SANIBEL CAPTIVA COMMUNITY BANK Account 29083439 |
7500 COLLEGE PKWY Number:
mM + FL 33807 Account Ownsr(s) Name & Address
CASEY D CROWTHER
MARGARET CROWTHER

Agreement Date: 12/06/2019 _ By. Kenne.h Sequra
D EXISTING Account - This agreement replaces previous egreement(a).
Account Oeseriptian: HOUSEHOLD

Initial Depostt $ 100.00_ Source: GHECK NORTH FORT MYERS Fi. 33917

Ownership of Account - CONSUMER (Select One and Initial) | Additional information:

1 Singte-Party Account Trust-Separste Agresment ___

Bl Muitigte-Party Account AL\LS-

C1 Muttiple-Party Account - Tenancy by the Entlret es _

O ater

Rights at Death (Selsct One and initial}

} DD Singte-Party Account .

GI Multipte-Party Account With Right of Sunivorsip = “7A Signaturo(s). Tho undbreigned carlifies tha acouracy of the Information haste tas

(2 Muttipte-Party Account Without Right of Gurvivarship Hoe ee a ee a a oper Histary endia havo

0 Single-Party Aoceunt With Pay On Death —— acrodt roportl proparaa credit report on the uncbralpped asindividuats,

(CO mutupte-Perty Account With Right of Survivoretip | Tigummugalaneiousentoreatd n cory andereato fre tanrs ofthe
end Fey On Dealh Terms & Conditions ‘Truth in Savings DO Funds Availablaty

Pay-On-Desth Beneficieries, To Add Pay-On-Death Beneficaries Name Ono or hore:
&]) Gectronic Fund Transfers [ Privacy &] Substitute Checks

O1 Commen Festus O

The interna) Revenue Service doea not require your consent to any
provision of this document other than the certifications required to
avold backup withholding.

Ownerehip of Account - BUSINESS Purpose LD, # C836-104-85-322-0 0.0.B. 09/02/1985

© Sole Proprietorship 0) Single-Member LLC [] Partnership
DO LLC atctax classification: O Coom 0 scope CO Pannership)
0 CCosporation © 8 Corporation DD Nen-FAofit

0 LD. # C836-561-85-783-0  —v.0o.8. ___ 08/03/1985
Business:

Backup Withholding Certifications (von-"LLS Parsoss* - Ute separate Form We8} (a): [. ]

et tight, , GASEY D CROWTHER |
catty oe eo sly Tha the statements madia in lus section ate trua.

LO. # D.OB
fY TIN: 593-88-8937 Tha “axpayer (dentificallon :
Number (TIN} shown Is my correcl taxpayer KentHication number, [

(4): Ix

BH Not Sublect to Backup Withholding, Iam NCI subject to backup
wiltthokiing efiher because] have 'ot been notified flat ! am abject 10 backup

aibholding 33.2 recut of a falture 10 report all interest or dividinds, or Ilse internat
Revenue Sersice has notified me that | am no longer subject ta sackup withholding. Lo. # DOR.

OO Exampt Recipient. | em an exempt rociplent under tha Internal Revenue 03 Convenience Accaunt Agent (Single-Party Accounte Only)
Service Regulations. Exempt payee code (Heny) =. __
[.

FATCA Cada. Tha FATCA code entered on this form (if ery) indicaling that Iam
exempt from FATCA reporting [s correct.

U.S. Person. | am a U.S. citizen or other U.S. arson (us defined

TERSOTS-

Sioraturo Cord-Fl.
Bankers Bysterat VMPO
Wolters Kaswar Finencisl Gorvicss ©2016 Page 1 of

EX_89_001

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