EFTA01372843.pdf

715:2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summar 3A. Individual Details (for all partes) Indrviduals Name: Date of Birth: Country of Resdence: Country of Citizenship: c/o HBRK Associates Has client resided outside of lusiher country of nationality for yes I No Address of primary residence: •75 Lexington Avenue, 4th Fl New York NY 1O022 USA 5 years or more' Profession/Occupation: Tax ID / SSN: Current Employer: Position/Title/Rank: Address of employer: Does the person work as senior executive of a DBirecognized regulated entity in the financial ndustry> or an entity listed on a DB-recognised exchange> (Not applicable for operating enbties ves 1 rto Is the individual a Politically Exposed Person (PEP)?(Y Yes desaibe) i , yet No To the best of your knowledge, is the individual related to an employee of the DB grouP7(1FOCI* . Family : Fnendship I 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 Yegdessiber) If applicable, indicate which bank officers have met the person: Magi! where and when the client meeting(s) took place: Client Private Ckent Place of Bank Officer Name(s) Bank Office: Other Location (specify): Date: Domicile: Business: 0 • 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(S): 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: Country: Est Assets Under Mgt: Institution: Country: Eft Assets Under Mgt: httpe://dbforcepb.my.salesforce.comiseNlet'servlet integrahonThd=0 N30000000D9D4ed=5006000000TIEyC&IcEl&linkToken=VmpEPSxNakFaT. . 18:25 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0066738 CONFIDENTIAL SDNY GM_00212922 EFTA01372843