EFTA01448705.pdf

EXHIBIT A In connection with authorization provided in the DB InSight Agreement for On-Line Statements, the following are additional current and future custody accounts of Account Holder(s) requested to be available through the DB InSight service: Legal Entity Name: Account Number(s): Authorized this day of . 200 Customer Name: Jeffrey Epstein Customer Name: Signature: Signature: Title flf App.): Title of App.): Email Address REQUIRED): Email Address REQUIRED): [Executed also on behalf of the Associated Account Holders as defined in the Terms and Conditions, if any) CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0 103805 CONFIDENTIAL SDNY_GM_00249989 EFTA01448705