EFTA01392643.pdf

ATM/Debit Service You agree that the retention or use of the ATM/Debit card constitutes acceptance of the terms and conditions of the Cardholder Agreement contained in the Terms and Conditions of Deposit Accounts. Internet Banking Service If you have selected to receive Internet Banking Services. yoo understand that you will be required to eater into a separate Internet Banking Services Agreement with DBTCA before you can access the Internet Banking Service. Acknowledgement of Receipt of Privacy Notice By signing at low, you acknowledge receipt of DBTCA's Privacy Notice included in the Application Package. Non-US Individuals: Confirmation of Tax and Compliance Responsibilities. You confirm that it is your responsibility to fulfill any tax obligations and any other regulatory reporting duties applicable to you in any relevant jurisdictions that may arise in connection with assets, income or transactions in your account(s) and your business relationship with DBTCA. Non-US Organizations: Confirmation of Tax and Compliance Responsibilities. You confirm that it is your responsibiNty to fulfill any tax obligations and any other regulatory reporting duties applicable to it in any relevant jurisdictions that may arise in connection with assets, income or transactions In your aocoungsl and your business relationship with OBTCA. Furthermore, you confirm that the necessary information (to the best of your knowtedge and capabilities) is made available no less than annually to the relevant beneficial owner(s), settlor(s), beneficiarylies), pertner(s), etc to enable hirnlhod them to fulfill any respective tax obligations that may arise for himihed them in connection with your business relationship with DBTCA. Please complete and attach separate W-8 or W-9 documentation as applicable. Terms and Conditions and Representations By signing below, you acknowledge receipt of the Terms and Conditions for Deposit Accounts attached to this Application Bad agree to be bound by them. In addition, you agred to notify us immediately of any material change to the information provided by you on this Application. You represent and warrant that all of the information provided by you on this Application is accurate The Terms and nditions lor Deposit Acco are subject to change. Accept You ndeistend that t eptance by DBTCA 1 I3 ntworilitisialtma Joint Account Holders Signature kazwmgamilt„Ntss. Date ,.. two?5' 2,-;.;aleast.:..---r---s--z'± a ,... .zty ,,2..„.- „..,-,e. ,...saa 14 9.- 9.- ''.445 Oggilnr arakaaraWaSnalalgtylaftfr b ir at e , isqt 131$1;;4! kcit. , Atevi.e.e)atn ;)-fr 5II;el) I i P "WC 2- '1 11,4":" n ; ... 2-n :»1 -e r '1 1-:- 1Ono .4 ' 79 •"1111:". . 'Sr/ rk Me. * 3 i'll v 4II,. i na % . 15t•' r t-: tariv.f. • % Irela . aity.%. : KY. a a.. 4- AFC az. alliftliineWelatataliaggel 9 •A ra) 4.1561617. 1" rI' r .4 ;YAW n iMilt iti kr v.- •• - A 4=1 cc ' OTgA. ) t.. Nan)e f. to') :anti . fi r VagilgghNfEa "14- mr.-1,2.0.., frti o • ;Vs:ililVatt.W4a- t re , vims asia • ,..%we. ra 6fr a, 13-AWN-DWI 013059.032613 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0097903 CONFIDENTIAL SDNY_GM_00244087 EFTA01392643