📄 Extracted Text (411 words)
715:2019 KYC Print
One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summar
3A. Individual Details (for all partcs)
Indrvkluars Name: Erika Kellerhals - Date of Birth:
Country of Rezdence: USA Country of Citizenship: USA
Has client resided outside of
hrsiher country of nationality for yes fir No
Address of primary residence:
5 years or more>
Profession/Occupation: Attorney Tax ID / SSN:
Current Employer: Kellerhals Ferguson Kroblin PlIC Position:Title:Rank
Address of employer: 9100 Port of Sale Mall, Ste 15 St. Thomas USVI 00802
Does the person work as senior executive of a DB.recognized regulated entity in the financial
ndustry' or an entity listed on a DB-recognised exchange' (Not applicable for operating enbties yes ,it No
, yes Ir. No
Is the individual a Politically Exposed Person (PEP)?(K Yes desaibe)
To the best of your knowledge, is the individual related to an employee of the DB grouP7(1FOCI* Family - Fnendship 1
- , None
cr Friendship, dente)
To the best of your knowledge, is the individual party to a non -banking relationship with Deutsche
Bank (e.g., external legal counsel, client referral source, supplier of goods or servrcesp(f Yes —i
Yes its
Indicate where and when the client metting(s) took place:
If applicable, indicate which bank officers have met the person:
Client Private dent Place of
Bank Officer Name(s) Bank Office: Otter Location (specify): Date:
pomicile: Business:
I.
, Wealth Details for this individual are not filled in, because they are the same as for the following person:
3B. Wealth Details (Only for parties requiring source of wealth description as indicated in Section 2)
Nature of the Individual's Business:
Primary Country of source of wealth/source of Funds'
Primary industry of source of Wealth/Source of Funds'
Summarize Source of Wealth: i. • Business Owner Salary/Earnings Investment Inheritance/Gifts Other:
Further Describe Source of Wealth /Detail the history of wealth fo each of the sources: (e.g. For truss, how did settlor accumulate wealth' For inheritance, how did
family accumulate wealth'For business owners, how long in business, how many employees, level of profitability' Indicate type of business, countries of major
activities, important business partners.)
Estimated Annual Income($): Estimated amount of Investable assets(S):
Estimated Net Worth($): Amount of assets planned to invest with PWM($):
Other Known Financial Institutions:
Institution: Country: Est. Assets Under Mgt:
Institution: County: Est. Assets Under Mgt:
Institution: Country: Est. Assets Under Mgt:
https:ildbforcepb.my.salesforce.comiseNlet,serviet integration7ild=01N30000000D9Di&eid=50060000001aNfy&ic=1&linkTokenaVmpFPSzNakF4T1... 20:25
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0066766
CONFIDENTIAL SDNY GM_00212950
EFTA01372865
ℹ️ Document Details
SHA-256
6cae8a6b29e5bb831229c415e803a0182e6c48e640a1c5ce5965fe406736084d
Bates Number
EFTA01372865
Dataset
DataSet-10
Document Type
document
Pages
1