📄 Extracted Text (1,233 words)
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B1395%0300
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0001406
EFTA_00014880
EFTA00165664
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Account Title and Joint Acipligation filtii*Satioh
Souther. Trust Comma, r. . .
Name of Account Title Joirit Applicant
Beat name. first name, middleiritfatlor,BitsilS7e anfrierne, test nine. Middle initial)
Sorrel Security Number or:Taxpayst ID Number • Social Security friurnterer 7;)xpayarpNuNw.
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Croy. City, State snit Vecdb
regrown 119.7:"Iirr/7.
HMIS Telephone Number
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Business Telephone:Number eusteggferAPticroffifffiwe
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Dated Birth
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tame otEmployer Name offirnployer
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Notice of Customer Identification
Important Information
TO help the giiviniment fight the landing ofterioriiM and Moneyiiimderingactivities,Eederal law requires ail financial
insfifirtions to obtain; veriftend record information that identifies eactiperson who eatabliihes anaciount, irweitthent Or
Other: buiineet relationship with afinancial instittititin:Thiirneins that we will aek foryoUr name: address. and other
information that will allow us to identify you. We may.also ask to seeidentifying documentssuch asa certificate of
formation eroded atandingliegal entities) orrs peasPorter otherphoto identification findbridualst
FU.Notice
.Governmintafrules.have alto broadened the scope of the:flank's obligations to aid In the fight against money laundering
and terrorist financing; these rules call for an active Involvement of both assetmanagement limns and their.thents. FOf
nowand existing clients we currently have to legal obligation to ask ourcustomers questions regarding their identities,
addresses, source of hinds and. iftecessary,legalrepresentaiivea a' uthorized signatories, beneficial owners or control
structures and to collect requisite documentation to subtitandate the iriformition.•Also. enhanced anti-moneylaundering
rethinernente(equire:Nu should any Ofthe'sibOve Personal or instititiorial infOrmitiOn change, our clients would be
'obliged to:immediately notify us of the change(s) and proVide.us with relevant documentation to verify these changes.
• •
Telephone, Facsimile or Email Itistrtictions
By signing' below, you agree theft,from ;imam time. oufrnali give instructions by tetiphona.fecsimite or email regarding
•the abotre captioned accounts) (defined herein es 'Verbal Inatructione). it is understood that the ask of Verbal
Instructions being given by person or persons purported to be yoti is.your town. Abtent the gross.negligence orwBHul
misconduct of Oousche Bankyrusi Company Crnerices (:781t4)..you tiptoe toindervinifir and hold:harmless OBTCA. for
any ilainis..lostel: expenses, edit brenorneyo' feet resulting frOm OBTOft'S acting trpon such misunderstood end
unauthorized Verbal Instruction!: You understand ihit OlITCP maituk shall not beiequired to, sookiierifieetion of your
.verbal: facsimile or email irisiructioni by catilseek. In case of doubt. DUCA may in its joie discretion refUseltrexectite
your Verbal Instructions of antpart thereof, without incurring anyliability. 0171t.ik.ii under no obligatIori to execute your
;VerballnstryotiOnSIO transfer lends arsticuiltieStoenyaccOunt(s)wlihont written instructions bearing yourOriginal
signature
Joint Acctiiint Disclosure. .
You haveopenede joint itocciturt with :DitiClA and ecanoveledgc'rticeilit ortite following,information) 'ibis deposit and any
additions to the account shalltecomeihe property of each owner as joint tenants, and Callicalrney refeeiethe entire
account to any owner:eluting the lifetime of all owners;.DEITCAt may honor Sheeks.,orders or withdrawal 'requests; frorn
any owner during the lifetime of owners. The Bank may be required by service of legal process to remit funds.heid.in
the joint account to satisfy a judgment entered aealnst, or other valid debt incurredby. any.owner 97 the account lif3TCA
may honor checks: orders-or whhdrawal iequeatefrern the aeronaut) otter the death of arty oWnerfsfand mey trait the
account at jhe sale oroperti of.fba'sennaarfel after the deathof'antfrsitincriath Uniiis DBTCA receives Wriffett.notice
signed by any owner. natio pay or deliver any Wins deposit or addition. or seenial.087CA shall not be labia to any owner
for:continuing to honer cheeks: orders or withdrawal requests:from any owner After: the receipt;of thenoticereferred to
in the prevIths sentence, OBTCA may require the written &Any or as joint any further payments
n e or
or deliveries.
tiawm•olot,
011869.032613
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0001407
EFTA_0001488 I
EFTA00165665
ATM/Debit Service
You agree that 4hsretention or use.of the ATM/Debit card &institutes acceptance of the terms and conditions ol. the'
Cardholder Agreement contained in the Tormi end Conditions of Dap* Ace*Otis.
Internet Banking Seevice
if yea have selected io mceivethiemet Banking Services, you understand that you will be requited:to enter.intee
separate Internet. Banking Services Agreement with D87CA before.you can access the.Internet.Etanking Science.
Ackhowledgernentof Receipt of Privacy Notice
By signing belovii, you acknowledge receipt of DBTCA's Piivacy Notice Included in the Application Package.
Non-US Individuals: Confirmation of Tax and Compliance Responsibilities.
You' onfirm thatit isyour responsibility to fulfill any-tax obligations and any other regulatory reporting duties applicable.
toyou in any ieleVant iwisdietions that:may arise in connection with assets. income or transactions in Yotii acCount(s)
and your busineSsrelationship with DEITCA,
Non-US Organizations.: Confirmation of Tax, and C0mpliance Responsibilities:
YOUcol-4nm that it is your responsibility to fillfill any tax obligations and any other regulatory.reporting duties apPlicable
to it in any relevantiurisdietioris that may arise in connection with eases, income or transactions in Your account(s) and
your business relationship with DaTtA. Furthermore. you confirrh that the neeessary infoimation (to the bait of youi
knowledge and capabilities),is made available noless thenannually to tekieeez beneficial owner(s), aettior(s),
boneficiarylies), partner's), etc. to enable Iiirrithed them to fulfill any respective tax obligations that may arise for him/heir
there: in connection With your birainess relationship with 087CA.
Please complete and attach separateWs9 or W-9 documerdation 88:applicable.
Terms and Conditions and Representations
By signing below, you acknowledge receipt thitie Terms and Conditions fer Deposit Accounts attached to. this
Application and agree to hebeund by them. In addition, you agree ter notify us immediately of any material change to.
the information provided by you on this Application.
'You represont arid:warrant that all of the itifoimatitin provided or yeu oriShis Application is act:mate
The Terms and Conditions kir:Deposit Accounts are subject-M change.
Acne
try 087CA.
Act:WM Nelda
Joint Account Holder's Signature-- •
Only Reyiewedb.
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CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) DB-SONY-0001408
EFTA_00014882
EFTA00165666
IM WITNES.S.WIEROF,:the undersigned, by and through its authorized officer, has caused this instrument to be -
emitted on this datelisted below.
(FORicISIOES4 USERS,
Southern TrueScdrppayty,.bic
WOO ALKOT.HE8:USERS)
*P29nt tiaffYit "
21 .1hte.4:0112
tetelet0101.13
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0001409
EFTA_00014883
EFTA00165667
ℹ️ Document Details
SHA-256
cb6c27471d15b1d964cb9c4798a58f09d08ddf62affa601febb28d19c1a7ebfa
Bates Number
EFTA00165664
Dataset
DataSet-9
Document Type
document
Pages
4
Comments 0