EFTA01392986.pdf

BY SIGNING BELOW CLIENT ACKNOWLEDGES THAT: (I) 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 APPLICATION IS ACCURATE. CLIENT ACKNOWLEDGES THAT THIS ACCOUNT AGREEMENT CONTAINS A PRE-DISPUTE ANIMATION CLAUSE AT SECTION III. PAGE 5, AND CLIENT AGREES TO ITS TERMS ALL ACCOUNT AGREEMENT SIGNATORIES MUST INITIAL). INITIAL HERE: THE INTERNAL REVENUE SERVICE DOES NOT REQUIRE CUENT'S CONSENT TO ANY PROVISION OF THIS DOCUMENT OTHER THAN THE CERTIFICATION REQUIRED TO AVOID BACKUP WITHHOLDING, AND. IF APPLICABLE. THE CERTIRCATION REQUIRED TO EsrAsusx CLIENTS STATUS AS A NON-U.S. PERSON AND OBTAIN A REDUCED RATE OF WITHHOLDING. Important Information for ERISA employee benefit plan clients: U.S. DePertmerit of Labor regulatIOns reouke DBSI to disclose to a resoonsible 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 rated compensation. The disclosure is available mane, at httpliwww.pwm.db.comramericasrenierisa_disdosure_pcs.html. By signing below, you acknowledge that you are a fiduciary responsible for the procuremars of DBSI's services to the plan. you have read the disclosure and you understand the disclosure. Individual or point account (IF THIS IS A JOINT ACCOUNT. ALL ACCOUNT OWNERS MUST SIGN): CONFIRMATION OF TAX AND COMPLIANCE RESPONSIBILITIES Client acknowledges having sole responsibility to futile any taxobligations and any other regulatory reporting duties applicable in any relevant jurisdictions that may arise In connection with assets, income or transactions in Client's account(s) and business relationship with DB51. CHECK A BOX BELOW ONLY IF CLIENTS DO NOT WANT JOINT TENANTS WITH RIGHTS OF SURVNORSHIP OR TENANTS BY THE ENTIRETIES. CLIENTS SPECIFY INSTEAD: O Community Tenants in common: Or CI Pro ifor mauler couples in canal , each spouse retains 5O% interest In the community property upon death of the first spouse). Signature Date 7.-a 4-f Print Name _Tarsi \ GeV SSN/EIN Signature Date Print Name SSN/EIN Sgnattire Date Print Name SSN/EIN Corporation partnership, trust or other entity: CONFIRMATION OF TAX AND COMPLIANCE RESPONSIBILITIES diem acknowledges having solo responsibility to fulfill any tax obligation:, and any other regulatory reporting duties applicable lo in any relevant jurisdictions that may arise in connection with assets. income or transactions in Client's accounts) and business relat kinship with DBSI. Furthennoro. Client confirms that the necessary Information (to the best of Client's knowledge and capabilities) is made available no leas than annually to the relevant beneficial owner's). settIoris). benehciary(ies). partner(s). etc. to enable such person(s) to fulfill any respective tax obligations that may arise for such person's) In connection with Client's business relationship with DBSI. a Entity Southern Financial LLC 6643799192 Name Employer ID No. Signature of Officer. Partner. Trustee. Authonred Pa ).---- Date 7 —sci—n Jeffrey Epstein Print Warne/Tale Signature of Officer. Partner. Trustee. Authorized Party Date ▪ nt Name/Title Signature of Officer, Partner. Trustee, Authorized Party Date Print Name/ isle L 13-AWM43198 012145 032813 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0098326 CONFIDENTIAL SDNY_GM_00244510 EFTA01392986