📄 Extracted Text (2,085 words)
Deutsche Bank
Private Wealth Management
Corporate Account Information Form
This form is for informational purposes only.
Corporate Details
Account Number:
Account Title:
LEGAL ADDRESS
ATTN:
Address:
City:
Province/County/Subdivision:
Business Phone Number:
Email Address:
Entity Information
Type of Entity (check one):
o Corporate
State: Zip/Postal Code:
Country:
MAILING ADDRESS (if different)
ATTN:
Address:
City:
Province/County/Subdivision:
State: Zip/Postal Code:
Country:
Fax Number:
Client Advisor:
o Holding Company
o Corporate Pension/Profit Sharing Plan
o Financial Organization
o LLC
o Private Equity Fund
o Delaware LLC o Investment Advisor
o Venture Capital Fund
o Hedge Fund
o Government Entity/Agency o Sole Proprietor o Other:
Is client an institutional account by one of the following definitions:
o Bank, Savings and Loan Association, Insurance Company or Registered
Investment Company;
o An investment adviser registered either with the Securities and Exchange
Commission under Section 203 of the Investment Advisers Act of
1940 or with a state securities commission or any agency or office
performing like functions;
o Other Entity (whether a natural person, corporation, partnership, trust or
other) with total assets of at least $50 million
If client meets any of the institutional definitions above, does client
waive Deutsche Bank's suitability obligation under Financial Industry
Regulatory Authority (FINRA) 2111? o Yes o No
Liquidity Needs: o Low (Somewhat Important) o Medium (Important) o High
(Very Important)
EFTA01467725
Time Horizon (approximate year account owner expects to achieve the
financial goals for this account):
OR o 10 years or longer
Year
Total Investments
Please note the investment types in which Client currently invests or owns
(whether with DBSI and/or with other financial institutions) by indicating
the
estimated value of those investments.
Equities:
Options:
Fixed Income:
Mutual Funds:
Business ID:
Number of Authorized Parties:
Country of Incorporation:
Date the entity was formed or incorporated:
Nature of Business:
Principal Place of Business:
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ETFs:
Real Estate Property
(excluding Primary Residence):
Variable Annuities:
Alternative Investments (Hedge Funds and
Private Equity):
Structured Products:
Foreign Currency:
Tax Identification
Number:
Is the company publicly traded? o Yes o No
State/Province of
Incorporation:
EFTA01467726
Entity's Financial Details
Annual Income:
o Less than $50,000
o 50,000-99,999
o 100,000-249,999
o 250,000-499,999
o 500,000-999,999
o 1,000,000-2,499,999
o 2,500,000-4,999,999
o 5,000,000 and over
Net Worth:
o Less than $50,000
o 50,000-99,999
o 100,000-249,999
o 250,000-499,999
o 500,000-999,999
o 1,000,000-2,499,999
o 2,500,000-4,999,999
o 5,000,000 and over
Entity's Source of Wealth (Check all that apply)
o Inheritance or Gifts
o Corporate Executive
o Sale of Other Assets
o Professional Earnings
o Sale of Business
Federal Tax Status (check one):
o 0-15%
o 15.1-32%
o 32.1-50%
o 50.1% or more
Approx % of net worth that is
investable assets:
o Sale of Securities
o Public or Gov't Official
o Lottery or Gaming
o Individual Earnings
o Sale of Real Estate
o Corporate Earnings
o Business Owner
Please further describe the Primary Account Holder's source of wealth
including but not limited to employment (history if retired) earnings
(salary,
bonus, commission), name of businesses owned/sold (history of growth &
revenues, assets & liabilities, proceeds of sale). For inheritance/gifts
include
the amount, from whom, and how originally earned.
o Other (please provide):
Entity's Investment Experience
Investment Type
Experience
(Required)
EFTA01467727
Years of
Investing
Equities
Options
Fixed Income
Mutual Funds
Exchange Traded Funds (ETFs)
Variable Annuities
Real Estate Property (excluding Primary
Residence)
Alternative Investments
(Hedge Funds, Private Equity)
Structured Products
Foreign Currency
Account Investment Objectives/Risk Tolerance
Investment Objectives (please select up to two consecutive investment
objectives):
o Aggressive Growth: Investor is willing to accept substantial risk of loss
to the portfolio to obtain growth of capital with minimal or no current
income. Investor seeks return mainly from potential capital appreciation;
liquidity is of no primary concern.
o Growth: Investor is willing to accept increased risk of loss to the
portfolio with greater exposure to the equity markets or equivalent markets.
The
objective is long-term growth of capital. Investor seeks return mainly from
capital appreciation and/or higher yielding instruments.
o Income: Investor is willing to accept some risk of loss to the portfolio
with exposure to income producing securities in equity, fixed income or
equivalent markets. Investor seeks return mainly from income.
o Capital Preservation: Risk averse investor who is willing to accept
limited risk of loss to the portfolio with limited exposure to equity
markets risk
or equivalent risks. The objective is capital preservation with limited
potential for capital appreciation and current income. Investor seeks
stability
and a modest return on capital.
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None
No history
of any
transactions
Annual Activity Level (Select one)
Limited
(1-5 transactions
per year)
Moderate
(6-15
transactions
per year)
EFTA01467728
High
(Over 15
transactions
per year)
EFTA01467729
Do you have brokerage accounts with other firms? o Yes o No
If Yes, please list firm name(s):
Does the owner have any other DB accounts? o Yes o No
If Yes, please list account number(s):
Banking Account Information
Banking Name:
Banking Address:
City:
Banking Phone Number:
Accountant Name:
Accountant Address:
City:
Accountant Phone Number:
Authorized Party's Personal Information
Name:
Legal Address:
City:
Country of Citizenship:
Employment Status: o Employed
Occupation and Position:
Employer's Name:
Employer's Address:
City:
Length of Employment:
Home Phone Number:
Investment Experience
Investment Type
State: Zip/Postal Code:
Banking Email Address:
State: Zip/Postal Code:
Accountant Email Address:
DOB:
SSN:
State: Zip/Postal Code: Country:
If not U.S. (check one): o Resident Alien o Non-Resident Alien
o Self-Employed
o Retired
o Unemployed o Homemaker
o Student
State: Zip/Postal Code:
Business Phone Number: Email
Address:
Experience
(Required)
Years of
Investing
Equities
Options
Fixed Income
EFTA01467730
Mutual Funds
Exchange Traded Funds (ETFs)
Variable Annuities
Real Estate Property (excluding Primary
Residence)
Alternative Investments
(Hedge Funds, Private Equity)
Structured Products
Foreign Currency
Are you an employee of Deutsche Bank (DB), its subsidiaries or affiliates? o
Yes o No
If Yes, list name of DB employer:
Are you related to an employee of DB, its subsidiaries or affiliates? o Yes
o No
If Yes, list name of employee/relationship/name of DB employer:
Are you an employee of another broker-dealer? o Yes o No
If Yes, list name of broker-dealer:
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None
No history
of any
transactions
Annual Activity Level (Select one)
Limited
(1-5 transactions
per year)
Moderate
(6-15
transactions
per year)
High
(Over 15
transactions
per year)
EFTA01467731
Are you related to an employee at another broker-dealer? o Yes o No
If Yes, list name of broker-dealer/name of employee:
Are you an employee or related to an employee of Financial Industry
Regulatory Authority/other self-regulatory organization? o Yes o No
If Yes, list person and organization:
Is any owner now, or has any owner ever been, a senior corporate officer or
director, or does any owner own 10% or more of any publicly-traded
company's stock? o Yes o No
If Yes, provide name of company, publicly traded symbol and affiliation date:
2nd Authorized Party's Personal Information
Name:
Legal Address:
City:
Country of Citizenship:
Employment Status: o Employed
Occupation and Position:
Employer's Name:
Employer's Address:
City:
Length of Employment:
Home Phone Number:
Investment Experience
Investment Type
DOB:
SSN:
State: Zip/Postal Code: Country:
If not U.S. (check one): o Resident Alien o Non-Resident Alien
o Self-Employed
o Retired
o Unemployed o Homemaker
o Student
State: Zip/Postal Code:
Business Phone Number: Email
Address:
Experience
(Required)
Years of
Investing
Equities
Options
Fixed Income
Mutual Funds
Exchange Traded Funds (ETFs)
Variable Annuities
Real Estate Property (excluding Primary
Residence)
Alternative Investments
(Hedge Funds, Private Equity)
Structured Products
EFTA01467732
Foreign Currency
Are you an employee of Deutsche Bank (DB), its subsidiaries or affiliates? o
Yes o No
If Yes, list name of DB employer:
Are you related to an employee of DB, its subsidiaries or affiliates? o Yes
o No
If Yes, list name of employee/relationship/name of DB employer:
Are you an employee of another broker-dealer? o Yes o No
If Yes, list name of broker-dealer:
Are you related to an employee at another broker-dealer? o Yes o No
If Yes, list name of broker-dealer/name of employee:
None
No history
of any
transactions
Annual Activity Level (Select one)
Limited
(1-5 transactions
per year)
Moderate
(6-15
transactions
per year)
High
(Over 15
transactions
per year)
4
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EFTA01467733
Are you an employee or related to an employee of Financial Industry
Regulatory Authority/other self-regulatory organization? o Yes o No
If Yes, list person and organization:
Is any owner now, or has any owner ever been, a senior corporate officer or
director, or does any owner own 10% or more of any publicly-traded
company's stock? o Yes o No
If Yes, provide name of company, publicly traded symbol and affiliation date:
3rd Authorized Party's Personal Information
Name:
Legal Address:
City:
Country of Citizenship:
Employment Status: o Employed
Occupation and Position:
Employer's Name:
Employer's Address:
City:
Length of Employment:
Home Phone Number:
Investment Experience
Investment Type
DOB:
SSN:
State: Zip/Postal Code: Country:
If not U.S. (check one): o Resident Alien o Non-Resident Alien
o Self-Employed
o Retired
o Unemployed o Homemaker
o Student
State: Zip/Postal Code:
Business Phone Number: Email
Address:
Experience
(Required)
Years of
Investing
Equities
Options
Fixed Income
Mutual Funds
Exchange Traded Funds (ETFs)
Variable Annuities
Real Estate Property (excluding Primary
Residence)
Alternative Investments
(Hedge Funds, Private Equity)
Structured Products
Foreign Currency
Are you an employee of Deutsche Bank (DB), its subsidiaries or affiliates? o
EFTA01467734
Yes o No
If Yes, list name of DB employer:
Are you related to an employee of DB, its subsidiaries or affiliates? o Yes
o No
If Yes, list name of employee/relationship/name of DB employer:
Are you an employee of another broker-dealer? o Yes o No
If Yes, list name of broker-dealer:
Are you related to an employee at another broker-dealer? o Yes o No
If Yes, list name of broker-dealer/name of employee:
Are you an employee or related to an employee of Financial Industry
Regulatory Authority/other self-regulatory organization? o Yes o No
If Yes, list person and organization:
Is any owner now, or has any owner ever been, a senior corporate officer or
director, or does any owner own 10% or more of any publicly-traded
company's stock? o Yes o No
If Yes, provide name of company, publicly traded symbol and affiliation date:
5
12-PWM-0355
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None
No history
of any
transactions
Annual Activity Level (Select one)
Limited
(1-5 transactions
per year)
Moderate
(6-15
transactions
per year)
High
(Over 15
transactions
per year)
EFTA01467735
Beneficial Owner's Information
Name:
DOB or Date of Establishment:
Legal Address:
City:
Country of Citizenship:
Employment Status: o Employed
Occupation and Position:
Employer's Name:
Employer's Address:
City:
Length of Employment:
Home Phone Number:
Investment Experience
Investment Type
OR Entity
Name:
SSN or
TIN:
State: Zip/Postal Code: Country:
If not U.S. (check one): o Resident Alien o Non-Resident Alien
o Self-Employed
o Retired
o Unemployed o Homemaker
o Student
State: Zip/Postal Code:
Business Phone Number: Email
Address:
Experience
(Required)
Years of
Investing
Equities
Options
Fixed Income
Mutual Funds
Exchange Traded Funds (ETFs)
Variable Annuities
Real Estate Property (excluding Primary
Residence)
Alternative Investments
(Hedge Funds, Private Equity)
Structured Products
Foreign Currency
FINRA/Broker Dealer Affiliations (Please Answer All Questions)
Is any owner (or person with a beneficial interest in the account) either
(1) a senior military, governmental, or political official of any country,
or (2)
closely associated with or an immediate family member of such an official? o
EFTA01467736
Yes o No
Are any of the following employed by Deutsche Bank, its subsidiaries or
affiliates, employed by a member firm or registered broker-dealer, or
employed by FINRA or any other self-regulatory organization? o Yes o No (If
Yes, please complete below)
Accounts owners?
o Yes o No
Any member of the same household as the account owner? o Yes o No
Any person who materially supports the account owner?
Any immediate family member of the account owner?
Any person materially supported by the account owner?
o Yes o No
o Yes o No
o Yes o No
If you answered YES to ANY of the above, please provide the following:
Name of Employee:
Name of Employer:
Relationship to Account Owner:
None
No history
of any
transactions
Annual Activity Level (Select one)
Limited
(1-5 transactions
per year)
Moderate
(6-15
transactions
per year)
High
(Over 15
transactions
per year)
6
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EFTA01467737
Is any owner now, or has any owner ever been, a senior corporate officer or
director, or does any owner own 10% or more of any publiclytraded
company's stock? o Yes o No
If Yes, provide name of company, publicly traded symbol and affiliation date:
Will anyone else be entering orders: o Yes o No
If YES, please list name(s) (additional paperwork will be required).
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EFTA01467738
ℹ️ Document Details
SHA-256
b949cb1924d4b2bf38b6afcc53a35da4bbcdea6ea006bd22151c031796e31da5
Bates Number
EFTA01467725
Dataset
DataSet-10
Document Type
document
Pages
14
Comments 0