DIGITAL ASSET ACCESS & ONLINE ACCOUNT MEMORIAL DIRECTIVE
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Effective Date: ________________________________________________________
Place: _________________________________________________________________

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1. Parties
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This document is made on ____________________ (____________________) by:

Account Holder
Individual
Full Legal Name: _______________________________________________________
SSN / ID: ______________________________________________________________
Doc Series: ____________________________________________________________
Address: _______________________________________________________________
         _______________________________________________________________

In favor of:

Authorized Representative
Individual
Full Legal Name: _______________________________________________________
SSN / ID: ______________________________________________________________
Doc Series: ____________________________________________________________
Address: _______________________________________________________________
         _______________________________________________________________

2. SUBJECT-MATTER SCHEDULE & SPECIFICATIONS
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Accounts & Platforms Covered: __________________________________________
Instructions per Account (Close, Memorialize, Transfer):
    ____________________________________________________________________
Where Access Information Is Kept:
    ____________________________________________________________________
Data to Keep or Delete: ________________________________________________

3. EXECUTION & SIGNATURES
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Account Holder

Signature: _____________________________________________________________

Full Legal Name: _______________________________________________________
Date: __________________________________________________________________