EFTA01387987.pdf

One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summary 3A. Individual Details 'or all part es. Individual's Name: Date of Binh: Country of Residence Country of Citizenship: s client resided outside f his/her country of Address of primary ationality for 5 years or O yes :hi No residence- ore? Professon, Occupation N A Tax ID I SSN Current Employer: N A Position/Title: Rank Address of employer: N A Does the person work as senior executive of a DB-recognized regulated entity in he financial Industry? or an entity listed on a OB-ratogn ised exchange? (Not ElYes kw/. No pplicable for operating entities Is the individual a Politically Exposed Person (F£P)?(If Yes, describe) N/A O Yes ...4 r No To the best of your knowledge, is the individual related to an employee of the DB O Family O Friendship g None groupWit Family or Friendship, describe) NIA 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 IDYes .w" 4 No source, supplier of goods or services)?(if Yes,describe ) NIA If applicable, indicate which bank officers have met Indicate where and when the client meetings) took place the person: Client Oient Place Bank Officer Name(s) Bank Office: Private of Business Other Location (soecityi Date Domicile: O ❑ O • O O D O O nWealth Details for this individual are rot Mel ri because they are the Sate as for the following person. 38. Wealth Details (Only for parties recur, ng source of weaTh oesc—ptsr as rad need 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: DEtuartess Owner O Salary/Earnings • Investment LiInhentance/Gifts JOther. CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0091288 CONFIDENTIAL SDNY GM_00237472 EFTA01387987