EFTA01392674.pdf

ATM/Debit Service You agree that the retention or use of the ATM/Debit care constitutes acceptance of the terms and conditions of tie Cardholder Agreement contained in the Terms and Conditions of Deposit Accounts. Internet Banking Service It you have selected to receive Internet Banking Services, you understand that you will be required to enter into a separate Internet Bahking Services Agreement with DBTCA before you can access the Internet Banking Service. Acknowledgement of Receipt of Privacy Notice By signing below, you acknowledge receipt et DISTCA's Privacy Notice included in the Application Package. Non-US Individuals: Confirmation of Tax and Compliance Responsibilities. You confirm that it is your responsibility to fulfil, any tax obligations anc any other regulatory reporting duties applicable to you in any relevant jurisdictinns that may arise in tninertinn with assets, income or transactions in your account(s) and Your business relationship with DOTCA. Non-US Organizations: Confirmation of Tax and Compliance Responsibilities. You confirm that it is your responsibility to fulfill any tax obligations and any other regulatory reporting duties applicable to it in any relevant jurisdictions that may arise in connection with assets, income or transactions In your account(s) and you. business relationship with DOTCA. Furthermore, you confirm that the necessary information (to the best of your knowledge and capabilities) is made available no less than annually to the relevant beneficial ownerlsl, settior(0. beneficiaryhesf• partner's), etc to enable hirn/hed them to fulfill any respective tax obligations that may arise for him/her/ them in connection with your business relationship with DUCA. Please complete and attach separate W-8 or W-9 documentation as applicable. Terms and Conditions and Representations By signing below, you acknowledge receipt of the Terms and Conditions for Deposit Accounts attached to this Applitation and agree to be bound by them. In addition, you agree to notify us immediately of any material change to the information provided by you on this Application. You represent and warrant that all of the information provided by you on this Application is accurate. The Terms and Conditions for Deposit Accounts are subjec to change. Acceptance You understand that this ep,pt is subject to acceptance 08TCA C Y/ I ea AC034011 Holder's Signature Date' Jose Account Holders Signature Dote r-e-lx"447.45710 XMOTVIMplitnattliMI, AptI: • • ' Titttlx911:. r. 1,4"e!W‘2:4•".,;P:re 7::;',„ r.1;sern N %re 1?).%?Thee '44-.5,t • y2.*('‘#) 50rk61% . •*12,46,, Pat 1,70;tniiir.'Wenst"'Rifg#7 ,- 4"M ii•cVA- vi•i., )itet4a7ge liliWOAfOr. 11, 11AWM4)101 013859.032613 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0097935 CONFIDENTIAL SDNY_GM_00244119 EFTA01392674