EFTA01387991.pdf

One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summar 3A. Individual Details . 'a' , oc': es, ndividual's Name Date of Birth: Country of Residence Country of Citizenship' -4as C ert rescec c.aside Address of primary of hisiber country of nationality for 5 years or Yes t No residence- more? Profession, Occupation N A Tax ID: SSN Current Employer: N A Position/Title( Rank NSA Address of employer: N A Does the person work as senior executive of a DB-recognized regulated entity in the financial Industry? or a entity listed on a OB-recognised exchange? (Not OYes ri No applicable for operating entities Is the individual a Politically Exposed Person (PEP)7(i( Yes. describe) N/A Yes .4 No To the best of your knowledge, lathe individual related to an employee of the DB I,,,,) Family O Friendship g None groupWif Family or Friendship, describe) N/A To the best of your knowledge, is the individual party to a non-banking relationship with Deutsche Bank (e.g., external legal counsel, client referral OYes RN° source, supplier of goods or services)?(if Yam/nate ) WA If applicable. indicate which bank officers have met Indicate where and when the client meeting(s) took place the person. Client Client Place Bank Officer Narne(s) Bank Office Private of Business Other Location (soecityt Dare Domicile. o iii O • O O D O 0 nWealth Details for this individual are rot fi led o because they are :he same as for the following person. 3B. Wealth Details (Only for parties recur ng source of wea':h descrIption as Ind cated in Section 2) Nature of the Individual's Business: Primary Country of source of wealth/source of Funds? Primary Mdustry of source of Wealth/Source of Funds? Summarize Source of Wealth: 11Business Coen., O Salary/Earnings • Investment O Inhentance/Glts J Other: CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0091296 CONFIDENTIAL SDNY GM_00237480 EFTA01387991