EFTA01355843.pdf

Structured Products Agreement and Approval. Form Please Complete All Sections Account Nut Mgt Account 1.1001.. NLIG. - onctoli 5 C3 VtIvAN)c1PIL Account Type ettungttog Juan Toot Pang tering Tac tmy...I,.t4klc. Canunatnt Coo notation GLIM' uthss;i t NOTE: IRA and SALSA accounts are prohibited horn purchasing Structured Products. Account and Owner orMatit341: Provide 40(0061341illiCHMattOM for ciAll benaiicial account owner (-aient"). If more than one owom enisrs. tka Slav:hued Ploducts Agreement and Approval Suppkrocntary Form io this Agreement maybe required. 0. FoS: Allah lam Name nt locnodua Puska, ot E)4DCKos -se--c-pQr=1 G s-\-6 i 3,3 61 c:' ea) Fic) G-WW)CeV_ 133 , s—r —ric)(31AAS Pt al 41Unant, 01 0c0001:011VI US Vt9. si\-\ tci-MI•VDS nivu tt Seal to )40viiteant - 141h4ODIYUYY ErnIMann• nnaneLi 141011,.! SGL$ 114,.. r.; Addan -RS P.i&AC.-9, Ty00 at litro tutu. Patine -filNiAMat)L i0Ccivgic_s owevet. moitt(S) C4 tnnontiptovne than atte0,1( (Awn!: tm alttln4 trot tJ PAIMC*4444altrOt the acCOtu s niceTir; DARS1-.N) twD11(e) B Client(s) Financial Information Approx]rram Aggregate Sources of Income Aggro:ant-a Net Worth APRIV:imate liquid Nat Annual Income of Account (Approximate) Worth Excluding Principal Owner(s) kom All Sources Resklence Less than $50,000 Salary/Bonus 96 Less than 550,000 Less than 550,000 $50,000 - $99,999 550.000 - S99.999 550,000 - 599.999 S100.000 - 5249.999 5100,000 - S249.999 5100.000 - S249,999 $250,000 -S499,999 Other (speciiy): $250.000 - $499.999 5250.000 - 8499.999 S500,000- S999.998 $500,000- 5999.999 5500.000 - $999.999 f.1,000,000 - $2.499.999 $1.000,000 - S2.499,999 51,000.000 - 52 499.999 J2.500.000 - $4,999,999 2.500.0410 999 S2.500,000 - S4.999.993 /.5.LX-0.000 and 09ef [ S5,000,000 and mei /VW' 'WM IWO Olio!? anion/ CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) DB-SDNY-0041129 CONFIDENTIAL SDNY_GM_00187313 EFTA01355843