📄 Extracted Text (527 words)
PaC. 3 ac41::ynazur.)
If Non-US Beneficiary/Non-US Beneficial Owner is an Individual:
1. I hereby certify that for the purposes of taxation I am not a tax resident In any country other than the country/countries
indicated above.
2. I confirm that my ownership or other interest in the Entity. if any. is appropriately disclosed In accordance with
applicable laws and regulations in the countries in which I am tax resident and may be required to be reflected in my
tax filings.
3. I confirm that all Income or capital distributions received (or deemed to be received for tax purposes) by me from the
Arrannt(s) have been, and going forward will be, taken into account and included in my relevant tax filings if required by
the laws of the country (countries) of my tax residence.
If Non-US Beneficiary/Non-US Beneficial Owner is an entity:
1. I hereby certify that for the purposes of taxation the non-US Beneficiary/non-US Beneficial Owner is not a tax resident
in any country other than the country/countries Indicated in this self-certification.
2. I confirm that my ownership or other interest in the Entity. if any, is appropriately disclosed in accordance with
applicable laws and regulations in the countries in which I am tax resident and may be required to be reflected in my
tax filings.
3. I confirm that all income or capital distributions received (or deemed to be received for lax purposes) by me from the
Account(s) hay.) been, and will be, taken into account and included in the relevant tax filings if required by the laws of
the country (countries) of tax residence.
I agree that Deutsche Bank may disclose this Certification and any other information related to It or the Accounts) now
or in the future held with Deutsche Bank. to any relevant tax or governmental authorities of the country in which the
Account(s) islarehvel be maintained or of any country in which I may be liable to pay taxes. I release Deutsche Bank from
any obligations of bank secrecy, confidentiality and/or data protection under any applicable laws which might otherwise
preclude the disclosure of such Information. I acknowledge that the data protection laws of such other countries may not
afford the information the same protections which it receives in the country in which the Account(s) is/are/will
be maintained.
I understand that this waiver will remain In force until cancelled and notwithstanding cancellation It cannot be
terminated retroactively.
I declare that all statements made in this Self-Certification are, to the best of my knowledge and belief..correct And
complete. I undertake to advise Deutsche Bank promptly of any cha ircumstances o h am aware of and that
causes the information contained herein to become incorrect a nkwith a suitably updated
Certification within 30 days of such change in circumstances.
Jeffrey Epstein
PrIM Name of Signor Signature
04.28.2018
Data (mm-def.lryyY)
Copacly
Note: II swing on Wharf of an entity, please indicate the capaoly in WhICJI
you are signing (tor morn* Trustee. COrPOraleAndriand Director. etch
INTERNAL USEONLY: AC:COutit Nurnb0601)
42 2016 Deutsche Bank AG. An name reserved. WM167679 023611 041516 Page A2.2
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0062814
CONFIDENTIAL SDNY GM_00208998
EFTA01370176
ℹ️ Document Details
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48c134ec7d23fef938641b712dfed53e07177b5f34aab7843f4bd355ddbbac79
Bates Number
EFTA01370176
Dataset
DataSet-10
Document Type
document
Pages
1
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