EFTA01356690.pdf

KYC Print Page 14 of 43 One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summa 3A. Individual Details (for all parties) Individual's Name: Erika Kellerhals - Date of Birth: Country of Residence: Virgin Islands, U.S. Country of Citizenship: United States Has client resided outside of Address of primary residence: his/her country of nationality L.J yes ItZ. No for 5 years or more? Profession/Occupation: Attorney Tax ID / SSN: Current Employer: Kellerhals Ferguson Kroblin PLLC Position/Title/Rank: Attorney Address of employer: 9100 Port of Sale Mall, Ste 15 St. Thomas Virgin Islands, U.S. 00802 Does the person work as senior executive of a DB-recognized regulated entity in the financial ndustiy? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities O Yes .^.. Is the individual a Politically Exposed Person (PEP)?(if Yes desenbe) N/A ❑Yes RI NO To the best of your knowledge, is the individual related to an employee of the DB group?(if ❑ Family 0 Friendship E) None Family or Fnendship, 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 source, supplier of goods or 0 Yes M No services)?(if Yes,deScnbe) N/A If applicable, indicate which bank officers have met the Indicate where and when the client meeting(s) took place: person: Oient Private Client Place of Bank Officer Name(s) Bank Office: Other Location (specify): Date: Domicile: Business: LI 0 U U 0 U r1 0 L.J Wealth Details for this individual are not filled in, because they are the same as for the following person: 38. Wealth Details (Only for parties requiring source of wealth description as indicated in Section 2) Nature of the Individual's Business: Primary Country of source of wealth/source of Funds? Primary industry of source of Wealth/Source of Funds? Summarize Source of Wealth: 0 Business Owner OSalary/Earnings 0 Investment 0 Inheritance/Gifts 0 Other: Further Describe Source of Wealth /Detail the history of wealth for each of the sources: (e.g. For trusts, how did settlor accumulate weakh? For inheritance, how did family accumulate wealth?For business owners, how long in business, how many employees, level of profitability? Indicate type of business, countries of major activities, important business partners.) Estimated Annual Income(;): Estimated amount of investable assets($): littps://dbforcepb.my.salesforce.com/servlet/servlet.Integration9lid=0IN30000000D9Di&eid=5000e0000I N... 7/10/2019 CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) DB-SDNY-0042682 CONFIDENTIAL SDNY_GM_00188866 EFTA01356690