EFTA01392646.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 It you have selected to receive Internet Banking SerAces, yoo understand that you will be required to eater into a separate %lomat Banking Services Agreement with DBTCA before you can access the Internet Banking Service. Acknowledgement of Receipt of Privacy Notice By signing Or low, you acknowledoe 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 responsibility to fulfill any tax obligations arid any other regulatory reporting duties applicable to it in any relevant jurisdictions that may arise in connection with assets, income or transactions In your account(s) and your business relationship with DBTCA. Furthermore, you confirm that the necessary information (to the best of your knowledge and capabilities) is made available no less than annually to the relevant beneficial owner(sl, settor(s), berieficiary(ies). pertnerls), etc. to enable hirn/her/ them to fulfill any respective tat obligations that may arise for himihed them in connection with your business relationship with DBTCA. Please complete and attacb 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 aed agree to be bound by them. In addition, you awed 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 C • nditions for Deposit Acco are subject to change. Accept You lance by DBTCA. - Therriejasigiui Joint Account Holder's Signature Date 014 • "4-: Po Va 04 t" Im Jett!a ft s, •J• HgataSta, cw. • 4.4-7,,,it ret a s orn c• • ...e•CIT 4-0,44 uce,„ aWetti',„2:tr.teltatItaar.St .tattleiNafe ati O" ctr, .1.*:Pro ff.stsPFilanulChernr-.0WcWnnt. 4. - -r-Rwr-r LT SW 'keit ,•• rtt 7••!• it4;4.7'1 rat itat4 5artag yy itiMeactlf SW' Voce sr e rn "at eatt.,rst, 47;1O.$ ..,,200.sztata. Nara S"' dr 'at/Mat r „ CgrlIge••;t ; •••4. ifttt.crelrikt. tare . 14 / 4 ..,VP:1kik ..... cr ." ri • -••)••• NOC x. •••- vrt•• 0 to Ily4, 3 13-AWM.0101 013959.032613 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0097906 CONFIDENTIAL SDNY_GM_00244090 EFTA01392646