ARHMF

Avila Rodriguez Hernandez Mena & Ferri LLP

TRUST ACCOUNT DEPOSIT FORM

Client / Matter #: _______________ Amount: US$_____________________

Client Name: _____________________ (Client) Date Received: ________________

1. Please confirm that the funds are nominal or short term and may be held in an IOTA trust account under Rule 5-1.1(g)(2)-(3), Rules Regulating the Florida Bar. YES / NO (circle). Note that only trust funds that are nominal or short term may be deposited into an IOTA trust account. All other funds may need a separate interest-bearing account. 2. Other than Client, does any third person have an interest in these funds? YES / NO (circle). If so, please identify below the name and contact information of each such person (or attach documents containing this information). Note that such third persons may request and receive a full accounting regarding these funds. See Rule 5-1.1(e), Rules Regulating the Florida Bar. Name: ________________________ Address: ________________________________ Telephone: ____________________ Email: __________________________________ 3. Are these trust funds subject to an escrow agreement, settlement agreement, purchase and sale agreement, investment agreement or other document restricting the disposition of these funds? YES / NO (circle). If so, please attach a copy of such documentation. 4. Please state the reason(s) for which these trust funds were received in compliance with Rules 5-1.2(b)(5)(D) and (6)(D), Rules Regulating the Florida Bar (e.g., advance to pay future fees and/or costs, purchase price under contract, equity investment, settlement payment, etc.): ________________________________________________________________________________ ________________________________________________________________________________ 5. Were these funds received in connection with a transaction in which ARHMF is serving as a title agent or real estate settlement agent? YES / NO (circle). If so, these funds will be deposited in ARHMFs separate real estate trust account as per section 626.8473(8), Florida Statutes. I hereby confirm that: (1) all of the foregoing statements are true and correct; and (2) Client or any third person who has an interest in the funds has been or will be promptly notified that these funds were received in trust as required by Rule 5-1.1(e), Rules Regulating the Florida Bar.

By:

____________________________ Attorney Signature

Approved by Firms CFO: ______________________________ John Saavedra Date: __________________________

Name: ____________________________ Date: ____________________________

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