📄 Extracted Text (374 words)
Entity Self-Certification Form
Appendix 2: Non-US Beneficiary/Non-US Beneficial Owner Self-Certification Form
Deutsche Bank AG and Its affiliates (collectively, "Deutsche Bank') collect certain information, Including tax related
information, from their clients. Deutsche Bank collects this information to comply with certain local and international
regulatory requirements that are designed, among other things, to foster and support a tax compliant environment.
Although these requirements are not necessarily imposed by all countries, Deutsche Bank, as a global bank that strives to
achieve consistency in its practices among all of its regions, nonetheless requires this information be provided by clients
even if not required by regulation. Accordingly. Deutsche Bank Wealth Management Americas is writing to clients and
sending you this Self-Certification to complete.
As a Non-US Beneficiary/Non-US Beneficial Owner of Meetings) with Deutsche Bank Wealth Management, you are
required to state your residency (or residencies) for tax purposes.
While Deutsche Bank Wealth Management does not provide tax advice, you may contact your Relationship Manager if you
have questions concerning the Self-Certification process. If you have any questions about how to complete this Self-
Certification or about how to determine your tax residency status, please contact your tax adviser or local tax authority.
Entity Account Holder, please insert the Legal Name of Entity in #1 of Part 1 below and provide this Appendix 2 to each
Non-US Beneficiary/Non-US Beneficial Owner, collect the completed certification and return tt to your Deutsche Bank
Relationship Manager.
Part I
Appendix 2 Is the 'Non-US ElaneficlarylNon-US Beneficial Owner" Certification. This Appendix must be completed
and signed by each non-US Beneficiary and non-US Beneficial Owner of the entity, regardless of whether such
person Is a Controlling Person disclosed in Appendix 1. The attached Guidance to the Entity Self-Cerfificaflon
Form provides assistance for you to determine who the non-US Beneficiaries and non-US Beneficial Owners are.
JEGE, LLC
Legal Name of Enlist 10 wtch this Apperoo 2 relates
Jeffrey Epstein
Non-US BenefstegyMoniUS Beneficial Owner Name
01/20/1953
tats of Etsthf0ato e incorpocabon(rnelvddim7)
Tax.R0SILJercy
Country/Countries of Tax Residence
US Virgin Islands
If you have additional countries of tax residence, please attach a list of additional countries of tax residence to this form.
Wle167679 0228111141516
Pogo A2-I
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0062084
CONFIDENTIAL SDNY GM_00208268
EFTA01369665
ℹ️ Document Details
SHA-256
507163abfa50ecdfbb5adc6a786a1edb1cfc2c64321ec696fab33b4f8621f443
Bates Number
EFTA01369665
Dataset
DataSet-10
Document Type
document
Pages
1
Comments 0