EFTA01355744.pdf

BY SIGNING BELOW CLIENT ACKNOWLEDGES THAT:11) CLIENT HAS RECEIVED, READ, AND AGREES TO THE TERMS AND CONDITIONS OF THIS ACCOUNT AGREEMENT. INCLUDING THE APPENDIX WHICH CONTAINS IMPORTANT INFORMATION: AND (2) THE INFORMATION CONTAINED IN THIS ACCOUNT APPUCATION IS ACCURATE. Sar ng (K, EN sziegrait 14$0040 100.64/PrierCANDAIE.14 .111MtIVSWHIgIWIjali:01 NW.9 impv4.5 tetittaritc.e THE INTERNAL EVENUE SERVICE DOES NOT REQUIRE CLIENTS CONSENT TO ANY PROVISION OF THIS DOCUMENT OTHER THAN THE CERTIFICATION REQUIRED TO AVOID BACKUP IMTHHOLDING, AND. IF APPUCABLE, THE CERTIFICATION REQUIRED TO ESTABLISH CLIENTS STATUS AS A NON-U.S. PERSON AND OBTAIN A REDUCED RATE OF WITHHOLDING. Important Infonnation for ERISA employee benefit plat clients: U.S. Department of Labor regulations require DBSI to disclose to a responsible plan fiduciary Certain information In connection with the services that DBSI provides to a plan, to assist the fiduciary In evaluating the reasonableness of DBSI's services and Salad compensation. The disclosure Is available online, at hnp://wwwpwm.db.corn/amolcashinferisa_disdosure_pcstamt By signing below, you acknowledge that you are a fiduciary responsible for the procurement of IMISI's services to the plan. you have read the disclosure and you understand the disclosure. Individual or joint account (IF THIS IS A JOINT ACCOUNT. ALL ACCOUNT OWNERS MUST SIGN): CONFIRMATION OF TAX AND COMPLIANCE RESPONSIBILITIES Client acknowledges having sole responsibility o fulfill any tax obligations and any other regulator/ needing duties applicable In any relevant lurisdictions that may rinse In connection with assets, income or transactions in Client's accoundel and business kinship with 089. eRt6 3145§C011talMeit40.16ratft . 437.00ACC9litkniatiri - 00513000031ittoVIEVANISW4113rearFOES 41Etas-?stecWatasixtel'; D Tenants in common: or O Community for married couples I ins pouse reams 50% tritest in the community property upon death of the first spouse). 947/; tiSklc#30.6 ihri) OlikW04 EP•biln tSIStalt Signature Date Print NMITO SSWEIN Signature Date Print Name SSE N , . . .. Corporation. partnership, trust or other entity: CONFIRMATION OF TM AND COMPLIANCE RESPONSIBILITIES Client acknowledges having sole responsibility to fulfill any tax cbtigatiom end any other regulatory reporting duties applicable to in any relevant iwistlicti0nS that may ante in connection with assets. income or transactions in Client's /comings) and business relationship with OBSI. Furthermore, Client confirms that the necessary Information (to the best of Client's knowledge and capabilities) is made available no less than annually to the relevant beneficial ovmerisl, SettloelS), benellciargies), panned.). etc. to enable such person(s) to fulfill any respective tax obligations Mat may arise for such person(s) In connection with Client's business relationship with DBSI. Name of Entity Employer ID No. Signature of Officer, Panne,. Trustee, Authonzed Party Date Print Narne/Trtle Signature of Officer, Panne,, Trustee. Authonzed Patty Dale Print Name/Title Signature of Officer. Partner, Trustee. Authorized Party Date Pnnt NarnatTitle 12.0WM.0573 7 012145 011113 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0041004 CONFIDENTIAL SDNY_GM_00187188 EFTA01355744