EFTA01390373.pdf

BY SIGNING BELOW CLIENT ACKNOWLEDGES THAT: II) 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. CLIENTACKNOWLEDGES THATTHIS ACCOUNT AGREEMENTCONTAINS A PRE-DISPUTE ARBITRATION CLAUSE AT SECTION ILE PAGE 5, ANOC(IENT AGREES TO ITS TE3hASIALkACCOONT AGREEMENI SIGNATORIES MUSI thinIAL). INITIAL IIEFIE:, .1 St/7. ' DIE INTERNAL REVENUE SERVICE DOES NOT RFOUIRE CUENT'S CONSENT TO ANY PROVISION Of THIS DOCUMENT OIHER THAN THE CER rifiCArioN REQUIRED10 AVOID RACKUP WITHHOLDING. AND, IF AIM ICABLE. THE CERTIFICATION REQUIRED TO ESTABLISH CI IFNI'S STATUS AS A NON.U.S. PERSON AND OBTAIN A REDUCED RATE OF WITHHOLDING. Important Intonation for ERISA employee benefit plan chants: U.S. Department of Labor regulations moire DEISI to tastiest, to a responsible plan fiduciary certain information in connection with the services that DWI provides to a plan, to assist the fiduciary in evaluating Mu reasonableness of 0851's services and related compensation. The disclosure is available mine at httpfiwww.myrn.dtzeoriVernericashWerisa_disclosure_pos.Mml. By signing below. you acknowledge that you are a fiduciary responsible for the procurement of DlitSts services to the plan. you have read the dadoSure and you understard the disclosure. Individual or joint account OF THIS IS A JOINT ACCOUNT. ALL ACCOUNT OWNERS MUST SIGN): CONFIRMATION OF TAX AND COMPLIANCE RESPONSIBILITIES Client acknowledges having sole responsibally to fulfill any tax obligations and any other regulatory tapering duties applicable in any reinvent jurisdictions that may arise in connection wnh assets, income or transactions In Clients account(s) and business relationship with THISI. CHECK A BOX BELOW ONLY IF CLIENTS 00 NOT WANT JOINT TENANTS WITH RIGHTS OF SURVIVORSHIP OR TENANTS BY THE EMIREPFS CLIENTS SPECIFY INSTEAD: Tenants In Common; or O Community Property (for married couples In °slain states; each spouse retains 50% Interest in the community property upon death of the first spouse). Signature Date Print Name SSWEIN Signature Date Print Name SSWEIN Signature Date Print Nan* SSN/FIN Corporation, partnership, tract or other entity: CONRRMATION OF TAX AND COMPLIANCE RESPONSIBILITIES Client acknowledges haying sole responsibility to fulfill any tax obligations and any other regulatory reporting duties applicable to in any nilevaM jurisdictions that may arise on connection with assets. income or transactions it s accountls) and business relationship with 13B51. Furthermore. Client confirms that the necessary Intimation (to the best of Client's knotMedge and capabiaties) la made available no less than annually to the relevant benendal Owner(H. settlorfs). benellaarylies/. partnerls). etc. to enable such person(s) to fulfil any newsmen, tax obligations that may acne lor such parents) in connection with Client's business relationship with DBSI. po i S p D i Emily the Haze Trier ." ErnploYer 10 No / $igruit : illate14.0ditalltienintaiia.leneenzall Pang/ ilia, 4- X131(3 Pitinilinemtie SITMetum 0/ Officer. Pannailhistee. Authorized Party . ).1...e-a........._ At. ‘a.,......-RL—...-- tilis ills ii 5 Signature of Officer. Partner. "frusta% Authorized Party Date Print Name/Mort 13-AWIA4196 7 012145 032813 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0094860 CONFIDENTIAL SDNY_GM_00241044 EFTA01390373