EFTA01417492
EFTA01417521 DataSet-10
EFTA01417593

EFTA01417521.pdf

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7/15/2019 KYC Print DB PWM GLOBAL KYC/NCA: PART A KYC Case # : 01804531 One sheet must be established per relationship - list all accounts included in the relationship 1. Relationship Details Relationship Name: Relationship Manager: EPSTEIN, JEFFREY RELATIONSHIP:00000483290 Stewart Oldfield New PWM Relationship Relationship to PWM: Existing PWM Relationship If existing, please indicate since when the relationship exists, provide reason for new profile and attach old profile: ***This KYC is a periodic review for high risk remediation*** Original KYC1121946 Client Referral How Was the Client(s) Introduced? How long has the RM personally known the client? Does Deutsche Bank pay a retrocession or similar compensation to a third party for the introduction of this relationship? RM Prospect Intermediary/FIM Other Source (CIB, etc.) Please provide details (e.g. name of referral source, how many years RM personally has known client, etc.): Jeffrey Epstein reached out to Stew Oldfield on 3/7/17 to have a new acct opened under Zorro Management LLC and add two new signors to this new acct only. Yes (If Yes, describe): List all existing and new accounts involved in this relationship Legal Entity Account(s) 1 2 3 Account Name / Number The Haze Trust - Deposit- Butterfly Trust - Deposit- The 2007 Jeffrey E. Epstein Insurance Trust #3 - Deposit- Who is the primary contact person for the RM? (Note: This person needs to have signatory EFTA01417521 rights and/or information right for the accounts.): Opening Date (intended/actual) 2/27/2017 1/24/2014 10/16/2013 Darren Indyke Preferred method of contact(indicate phone no., fax no., e-mail address, etc.): No Booking Center: New York Status : 6. Approved 212-971-1307 https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4T1m 1/43 EFTA01417522 7/15/2019 KYC Print One sheet must be established for each account to be opened 2. Account Ownership Summary Account Name: Account Manager: The Haze Trust - Deposit stewart oldfield What is the purpose of the account (e.g. portfolio management, advisory account, custody services, long-term investment, payment/expense account)? this is a deposit account to hold cash for the trust Indicate from where the assets are expected to arrive? DB Group: Same Booking Center (indicate account number): DB Group: Other Booking Center (indicate DB location and account details): Other Institution — (Indicate name & location): Physical Deposits (specify cash, securities, cheques, ...): What is the expected size and frequency of regular inflows and outflows for the account (indicate estimated number and volume per month)?: collecting interest on current balance...no inflows/outflows What is the expected volume of assets and currency for the account approx. 90 days after opening? What is the expected volume of assets and currency for the account approx. one year after opening? Does/will the client have Assets Under Management (AuM) within DB under Eur. 3M? 21,063,409.16 21,077711.01 Yes No Please list all parties related to the account. For each party: Check if a source of wealth description is required for the party. Check the appropriate box to describe the relationship of the party to this account (> 1 can be selected). If none of the check boxes apply, describe the party's relation to the account in the "Other" column. Always describe the relationship between the parties in the last column. Please drill down to the ultimate/underlying Beneficial Owner(s). Legal Entity Description of Source of Wealth required Account Holder Parties related to this account EFTA01417523 Jeffrey 1 2 3 E. Epstein The Haze Trust Darren Indyke Trustee:; PIC Owner Settlor of Trust / Founder of Foundation Ultimate Beneficial Owner Signatory or Full POA Limited POA Financial Intermediary (FIM) Currency Currency USD USD Acct. Number (if available): Significant Shareholder (>=25%)NonPIC entity (indicate ownership %) Legal Representative Grantor/Settlor Founding Donor Other (please describe other roles and/or indicate relationship between parties) EFTA01417524 OTH:beneficiary of The Haze Trust; https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4T1... 2/43 EFTA01417525 7/15/2019 KYC Print 2. Account Ownership Summary Account Name: Account Manager: Butterfly Trust - Deposit stewart oldfield What is the purpose of the account (e.g. portfolio management, advisory account, custody services, long-term investment, payment/expense account)? This is a deposit account to hold funds for the trust. Indicate from where the assets are expected to arrive? DB Group: Same Booking Center (indicate account number): DB Group: Other Booking Center (indicate DB location and account details): Other Institution — (Indicate name & location): Physical Deposits (specify cash, securities, cheques, ...): What is the expected size and frequency of regular inflows and outflows for the account (indicate estimated number and volume per month)?: no inflows/- outflows What is the expected volume of assets and currency for the account approx. 90 days after opening? What is the expected volume of assets and currency for the account approx. one year after opening? Does/will the client have Assets Under Management (AuM) within DB under Eur. 3M? 2.99 2.99 Yes No Please list all parties related to the account. For each party: Check if a source of wealth description is required for the party. Check the appropriate box to describe the relationship of the party to this account (> 1 can be selected). If none of the check boxes apply, describe the party's relation to the account in the "Other" column. Always describe the relationship between the parties in the last column. Please drill down to the ultimate/underlying Beneficial Owner(s). Legal Entity Description of Source of Wealth required Parties related to this account 1 Karyna Shuliak 2 EFTA01417526 3 Richard D. Kahn 4 5 6 7 Darren Indyke 8 Beneficiary of Butterfly Trust; https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4T1... 3/43 Account Holder PIC Owner Settlor of Trust / Founder of Foundation Ultimate Beneficial Owner Signatory or Full POA Limited POA Financial Intermediary (FIM) Currency Currency usd EFTA01417527 usd Acct. Number (if available): Significant Shareholder (>=25%)NonPIC entity (indicate ownership %) Legal Representative Grantor/Settlor Founding Donor Other (please describe other roles and/or indicate relationship between parties) beneficiary of the butterfly trust; beneficiary of the butterfly trust; beneficiary of the butterfly trust; beneficiary of the butterfly trust; beneficiary of the butterfly trust; Beneficiary of Butterfly Trust; Beneficiary of Butterfly Trust; EFTA01417528 7/15/2019 9 KYC Print 10 11 12 13 14 15 16 Estocado Rabuyo Butterfly Trust Erika Kellerhals Harry Beller Jeffrey E. Epstein Beneficiary of Butterfly Trust; Beneficiary of Butterfly Trust; Beneficiary of Butterfly Trust; Beneficiary of Butterfly Trust; Trustee:; Trustee:; grantor; https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N3BOOGOOOD9Di&eid=5093200e01EHPpb&ic=1&linkToken=VmpFPSxNakF4T1... 4/43 EFTA01417529 7/15/2019 KYC Print 2. Account Ownership Summary Account Name: Account Manager: The 2007 Jeffrey E. Epstein Insurance Trust #3 - Deposit stew oldfield What is the purpose of the account (e.g. portfolio management, advisory account, custody services, long-term investment, payment/expense account)? Checking account to hold funds for this trust. Indicate from where the assets are expected to arrive? DB Group: Same Booking Center (indicate account number): DB Group: Other Booking Center (indicate DB location and account details): Other Institution — (Indicate name & location): Physical Deposits (specify cash, securities, cheques, ...): What is the expected size and frequency of regular inflows and outflows for the account (indicate estimated number and volume per month)?: no inflows/- outflows What is the expected volume of assets and currency for the account approx. 90 days after opening? What is the expected volume of assets and currency for the account approx. one year after opening? Does/will the client have Assets Under Management (AuM) within DB under Eur. 3M? 259.05 259.05 Yes No Please list all parties related to the account. For each party: Check if a source of wealth description is required for the party. Check the appropriate box to describe the relationship of the party to this account (> 1 can be selected). If none of the check boxes apply, describe the party's relation to the account in the "Other" column. Always describe the relationship between the parties in the last column. Please drill down to the ultimate/underlying Beneficial Owner(s). Legal Entity Description of Source of Wealth required Parties related to this account 1 The 2007 EFTA01417530 2 3 4 5 Jeffrey E. Epstein Insurance Trust #3 Jeffrey E. Epstein Darren Indyke Richard D. Kahn grantor; Trustee:; Trustee:; Account Holder PIC Owner Settlor of Trust / Founder of Foundation Ultimate Beneficial Owner Signatory or Full POA Limited POA Financial Intermediary (FIM) Currency Currency usd usd Acct. Number (if available): Significant Shareholder (>=25%)NonPIC entity (indicate ownership %) Legal Representative Grantor/Settlor Founding EFTA01417531 Donor Other (please describe other roles and/or indicate relationship between parties) Beneficiary of The 2007 Jeffrey E. Epstein Insurance Trust #3; https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4T1m 5/43 EFTA01417532 7/15/2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summary 3A. Individual Details (for all parties) Individual's Name: Country of Residence: Address of primary residence: Profession/Occupation: Current Employer: Address of employer: Does the person work as senior executive of a DB-recognized regulated entity in the financial industry? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities Is the individual a Politically Exposed Person (PEP)?(if Yes, describe) To the best of your knowledge, is the individual related to an employee of the DB group?(if Family or Friendship, describe ) 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 services)?(if Yes,describe ) - 00000565313 Date of Birth: Country of Citizenship: Has client resided outside of his/her country of nationality for 5 years or more? Tax ID / SSN: Position/Title/Rank: If applicable, indicate which bank officers have met the person: Bank Officer Name(s) Indicate where and when the client meeting(s) took place: Bank Office: Client Private EFTA01417533 Domicile: Client Place of Business: Other Location (specify): Date: 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: Business Owner Salary/Earnings Investment Inheritance/Gifts Other: Further Describe Source of Wealth /Detail the history of wealth for each of the sources: (e.g. For trusts, 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($): Estimated Net Worth($): Other Known Financial Institutions: Institution: Institution: Institution: Estimated amount of investable assets($): Amount of assets planned to invest with PWM($): Country: Est. Assets Under Mgt: Country: Country: Est. Assets Under Mgt: Est. Assets Under Mgt: https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4T1m 6/43 EFTA01417534 7/15/2019 KYC Print Please indicate the family situation of the individual (marital status, other family members, etc.): https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4T1m 7/43 EFTA01417535 7/15/2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summary 3A. Individual Details (for all parties) Individual's Name: Country of Residence: Address of primary residence: Profession/Occupation: Current Employer: Address of employer: Karyna Shuliak - 00000489504 Does the person work as senior executive of a DB-recognized regulated entity in the financial industry? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities Is the individual a Politically Exposed Person (PEP)?(if Yes, describe) To the best of your knowledge, is the individual related to an employee of the DB group?(if Family or Friendship, describe ) 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 services)?(if Yes,describe ) Yes No Yes Family No Friendship None Date of Birth: Country of Citizenship: Has client resided outside of his/her country of nationality for 5 years or more? Tax ID / SSN: Position/Title/Rank: If applicable, indicate which bank officers have met the person: EFTA01417536 Bank Officer Name(s) Indicate where and when the client meeting(s) took place: Bank Office: Client Private Domicile: Client Place of Business: Other Location (specify): Date: 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: Business Owner Salary/Earnings Investment Inheritance/Gifts Other: Further Describe Source of Wealth /Detail the history of wealth for each of the sources: (e.g. For trusts, 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($): Estimated Net Worth($): Other Known Financial Institutions: Institution: Institution: Institution: Estimated amount of investable assets($): Amount of assets planned to invest with PWM($): Country: Est. Assets Under Mgt: Country: Country: Est. Assets Under Mgt: Est. Assets Under Mgt: https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4T1m 8/43 EFTA01417537 7/15/2019 KYC Print Please indicate the family situation of the individual (marital status, other family members, etc.): https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4T1m 9/43 EFTA01417538 7/15/2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summary 3A. Individual Details (for all parties) Individual's Name: Country of Residence: Address of primary residence: Profession/Occupation: Current Employer: Address of employer: Does the person work as senior executive of a DB-recognized regulated entity in the financial industry? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities Is the individual a Politically Exposed Person (PEP)?(if Yes, describe) To the best of your knowledge, is the individual related to an employee of the DB group?(if Family or Friendship, describe ) 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 services)?(if Yes,describe ) Yes No Yes Family No Friendship None Date of Birth: Country of Citizenship: Has client resided outside of his/her country of nationality for 5 years or more? Tax ID / SSN: Position/Title/Rank: If applicable, indicate which bank officers have met the person: Bank Officer Name(s) EFTA01417539 Indicate where and when the client meeting(s) took place: Bank Office: Client Private Domicile: Client Place of Business: Other Location (specify): Date: 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: Business Owner Salary/Earnings Investment Inheritance/Gifts Other: Further Describe Source of Wealth /Detail the history of wealth for each of the sources: (e.g. For trusts, 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($): Estimated Net Worth($): Other Known Financial Institutions: Institution: Institution: Institution: Estimated amount of investable assets($): Amount of assets planned to invest with PWM($): Country: Est. Assets Under Mgt: Country: Country: Est. Assets Under Mgt: Est. Assets Under Mgt: https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 10/43 EFTA01417540 7/15/2019 KYC Print Please indicate the family situation of the individual (marital status, other family members, etc.): https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 11/43 EFTA01417541 7/15/2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summary 3A. Individual Details (for all parties) Individual's Name: Country of Residence: Address of primary residence: Profession/Occupation: Current Employer: Address of employer: Does the person work as senior executive of a DB-recognized regulated entity in the financial industry? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities Is the individual a Politically Exposed Person (PEP)?(if Yes, describe) To the best of your knowledge, is the individual related to an employee of the DB group?(if Family or Friendship, describe ) 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 services)?(if Yes,describe ) Date of Birth: Country of Citizenship: Has client resided outside of his/her country of nationality for 5 years or more? Tax ID / SSN: Position/Title/Rank: No If applicable, indicate which bank officers have met the person: Bank Officer Name(s) Indicate where and when the client meeting(s) took place: Bank Office: Client Private EFTA01417542 Domicile: Client Place of Business: Other Location (specify): Date: 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: Business Owner Salary/Earnings Investment Inheritance/Gifts Other: Further Describe Source of Wealth /Detail the history of wealth for each of the sources: (e.g. For trusts, 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($): Estimated Net Worth($): Other Known Financial Institutions: Institution: Institution: Institution: Estimated amount of investable assets($): Amount of assets planned to invest with PWM($): Country: Est. Assets Under Mgt: Country: Country: Est. Assets Under Mgt: Est. Assets Under Mgt: https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 12/43 EFTA01417543 7/15/2019 KYC Print Please indicate the family situation of the individual (marital status, other family members, etc.): https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 13/43 EFTA01417544 7/15/2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summary 3A. Individual Details (for all parties) Individual's Name: Country of Residence: Address of primary residence: Profession/Occupation: Current Employer: Address of employer: Does the person work as senior executive of a DB-recognized regulated entity in the financial industry? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities Is the individual a Politically Exposed Person (PEP)?(if Yes, describe) To the best of your knowledge, is the individual related to an employee of the DB group?(if Family or Friendship, describe ) 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 services)?(if Yes,describe ) Date of Birth: Country of Citizenship: Has client resided outside of his/her country of nationality for 5 years or more? Tax ID / SSN: Position/Title/Rank: pplicable, indicate which bank officers have met the person: Bank Officer Name(s) Indicate where and when the client meeting(s) took place: Bank Office: Client Private EFTA01417545 Domicile: Client Place of Business: Other Location (specify): Date: 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: Business Owner Salary/Earnings Investment Inheritance/Gifts Other: Further Describe Source of Wealth /Detail the history of wealth for each of the sources: (e.g. For trusts, 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($): Estimated Net Worth($): Other Known Financial Institutions: Institution: Institution: Institution: Estimated amount of investable assets($): Amount of assets planned to invest with PWM($): Country: Est. Assets Under Mgt: Country: Country: Est. Assets Under Mgt: Est. Assets Under Mgt: https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 14/43 EFTA01417546 7/15/2019 KYC Print Please indicate the family situation of the individual (marital status, other family members, etc.): https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 15/43 EFTA01417547 7/15/2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summary 3A. Individual Details (for all parties) Individual's Name: Country of Residence: Address of primary residence: Profession/Occupation: Current Employer: Address of employer: Does the person work as senior executive of a DB-recognized regulated entity in the financial industry? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities Is the individual a Politically Exposed Person (PEP)?(if Yes, describe) To the best of your knowledge, is the individual related to an employee of the DB group?(if Family or Friendship, describe ) 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 services)?(if Yes,describe ) Date of Birth: Country of Citizenship: Has client resided outside of his/her country of nationality for 5 years or more? Tax ID / SSN: Position/Title/Rank: 7/25/1994 Switzerland Yes No X2488823 Yes No Yes Family No Friendship None Yes No If applicable, indicate which bank officers have met the person: Bank Officer Name(s) Indicate where and when the client meeting(s) took place: Bank Office: Client Private EFTA01417548 Domicile: Client Place of Business: Other Location (specify): Date: 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: Business Owner Salary/Earnings Investment Inheritance/Gifts Other: Further Describe Source of Wealth /Detail the history of wealth for each of the sources: (e.g. For trusts, 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($): Estimated Net Worth($): Other Known Financial Institutions: Institution: Institution: Institution: Estimated amount of investable assets($): Amount of assets planned to invest with PWM($): Country: Est. Assets Under Mgt: Country: Country: Est. Assets Under Mgt: Est. Assets Under Mgt: https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 16/43 EFTA01417549 7/15/2019 KYC Print Please indicate the family situation of the individual (marital status, other family members, etc.): https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 17/43 EFTA01417550 7/15/2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summary 3A. Individual Details (for all parties) Individual's Name: Country of Residence: Address of primary residence: Profession/Occupation: Current Employer: Address of employer: Does the person work as senior executive of a DB-recognized regulated entity in the financial industry? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities Is the individual a Politically Exposed Person (PEP)?(if Yes, describe) To the best of your knowledge, is the individual related to an employee of the DB group?(if Family or Friendship, describe ) 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 services)?(if Yes,describe ) Date of Birth: Country of Citizenship: Has client resided outside of his/her country of nationality for 5 years or more? Tax ID / SSN: Position/Title/Rank: If applicable, indicate which bank officers have met the person: Bank Officer Name(s) Indicate where and when the client meeting(s) took place: Bank Office: Client Private EFTA01417551 Domicile: Client Place of Business: Other Location (specify): Date: 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: Business Owner Salary/Earnings Investment Inheritance/Gifts Other: Further Describe Source of Wealth /Detail the history of wealth for each of the sources: (e.g. For trusts, 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($): Estimated Net Worth($): Other Known Financial Institutions: Institution: Institution: Institution: Estimated amount of investable assets($): Amount of assets planned to invest with PWM($): Country: Est. Assets Under Mgt: Country: Country: Est. Assets Under Mgt: Est. Assets Under Mgt: https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 18/43 EFTA01417552 7/15/2019 KYC Print Please indicate the family situation of the individual (marital status, other family members, etc.): https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 19/43 EFTA01417553 7/15/2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summary 3A. Individual Details (for all parties) Individual's Name: Country of Residence: Address of primary residence: Profession/Occupation: Current Employer: Address of employer: Does the person work as senior executive of a DB-recognized regulated entity in the financial industry? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities Is the individual a Politically Exposed Person (PEP)?(if Yes, describe) To the best of your knowledge, is the individual related to an employee of the DB group?(if Family or Friendship, describe ) 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 services)?(if Yes,describe ) Date of Birth: Country of Citizenship: Has client resided outside of his/her country of nationality for 5 years or more? Tax ID / SSN: Position/Title/Rank: If applicable, indicate which bank officers have met the person: Bank Officer Name(s) Indicate where and when the client meeting(s) took place: Bank Office: EFTA01417554 Client Private Domicile: Client Place of Business: Other Location (specify): Date: 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: Business Owner Salary/Earnings Investment Inheritance/Gifts Other: Further Describe Source of Wealth /Detail the history of wealth for each of the sources: (e.g. For trusts, 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($): Estimated Net Worth($): Other Known Financial Institutions: Institution: Institution: Institution: Estimated amount of investable assets($): Amount of assets planned to invest with PWM($): Country: Est. Assets Under Mgt: Country: Country: Est. Assets Under Mgt: Est. Assets Under Mgt: https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 20/43 EFTA01417555 7/15/2019 KYC Print Please indicate the family situation of the individual (marital status, other family members, etc.): https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 21/43 EFTA01417556 7/15/2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summary 3A. Individual Details (for all parties) Individual's Name: Country of Residence: Address of primary residence: Profession/Occupation: Current Employer: Address of employer: Does the person work as senior executive of a DB-recognized regulated entity in the financial industry? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities Is the individual a Politically Exposed Person (PEP)?(if Yes, describe) To the best of your knowledge, is the individual related to an employee of the DB group?(if Family or Friendship, describe ) 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 services)?(if Yes,describe ) Date of Birth: Country of Citizenship: Has client resided outside of his/her country of nationality for 5 years or more? Tax ID / SSN: Position/Title/Rank: If applicable, indicate which bank officers have met the person: Bank Officer Name(s) Indicate where and when the client meeting(s) took place: Bank Office: Client Private EFTA01417557 Domicile: Client Place of Business: Other Location (specify): Date: 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: Business Owner Salary/Earnings Investment Inheritance/Gifts Other: Further Describe Source of Wealth /Detail the history of wealth for each of the sources: (e.g. For trusts, 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($): Estimated Net Worth($): Other Known Financial Institutions: Institution: Institution: Institution: Estimated amount of investable assets($): Amount of assets planned to invest with PWM($): Country: Est. Assets Under Mgt: Country: Country: Est. Assets Under Mgt: Est. Assets Under Mgt: https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 22/43 EFTA01417558 7/15/2019 KYC Print Please indicate the family situation of the individual (marital status, other family members, etc.): https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 23/43 EFTA01417559 7/15/2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summary 3A. Individual Details (for all parties) Individual's Name: Country of Residence: Address of primary residence: Profession/Occupation: Current Employer: Address of employer: Does the person work as senior executive of a DB-recognized regulated entity in the financial industry? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities Is the individual a Politically Exposed Person (PEP)?(if Yes, describe) To the best of your knowledge, is the individual related to an employee of the DB group?(if Family or Friendship, describe ) 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 services)?(if Yes,describe ) Date of Birth: Country of Citizenship: Has client resided outside of his/her country of nationality for 5 years or more? Tax ID / SSN: Position/Title/Rank: No If applicable, indicate which bank officers have met the person: Bank Officer Name(s) Indicate where and when the client meeting(s) took place: Bank Office: Client Private EFTA01417560 Domicile: Client Place of Business: Other Location (specify): Date: 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: Business Owner Salary/Earnings Investment Inheritance/Gifts Other: Further Describe Source of Wealth /Detail the history of wealth for each of the sources: (e.g. For trusts, 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($): Estimated Net Worth($): Other Known Financial Institutions: Institution: Institution: Institution: Estimated amount of investable assets($): Amount of assets planned to invest with PWM($): Country: Est. Assets Under Mgt: Country: Country: Est. Assets Under Mgt: Est. Assets Under Mgt: https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 24/43 EFTA01417561 7/15/2019 KYC Print Please indicate the family situation of the individual (marital status, other family members, etc.): https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 25/43 EFTA01417562 7/15/2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summary 3A. Individual Details (for all parties) Individual's Name: Country of Residence: Address of primary residence: Profession/Occupation: Current Employer: Address of employer: Darren Indyke - 00000486405 USA Accountant Southern Financial LLC 6100 Red Hook Quarter B3 St Thomas 00802 Does the person work as senior executive of a DB-recognized regulated entity in the financial industry? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities Is the individual a Politically Exposed Person (PEP)?(if Yes, describe) To the best of your knowledge, is the individual related to an employee of the DB group?(if Family or Friendship, describe ) 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 services)?(if Yes,describe ) Yes No Yes Family No Friendship None Date of Birth: Country of Citizenship: Has client resided outside of his/her country of nationality for 5 years or more? Tax ID / SSN: Position/Title/Rank: If applicable, indicate which bank officers have met the person: Bank Officer Name(s) EFTA01417563 Paul Morris Indicate where and when the client meeting(s) took place: Bank Office: Client Private Domicile: Client Place of Business: Other Location (specify): Date: 9/6/2013 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: Business Owner Salary/Earnings Investment Inheritance/Gifts Other: Further Describe Source of Wealth /Detail the history of wealth for each of the sources: (e.g. For trusts, 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($): Estimated Net Worth($): Other Known Financial Institutions: Institution: Institution: Institution: Estimated amount of investable assets($): Amount of assets planned to invest with PWM($): Country: Est. Assets Under Mgt: Country: Country: Est. Assets Under Mgt: Est. Assets Under Mgt: https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 26/43 EFTA01417564 7/15/2019 KYC Print Please indicate the family situation of the individual (marital status, other family members, etc.): https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 27/43 EFTA01417565 7/15/2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summary 3A. Individual Details (for all parties) Individual's Name: Country of Residence: Address of primary residence: Profession/Occupation: Current Employer: Address of employer: Harry Beller - 00000487202 USA Accountant HBRK Associates, Inc 575 Lexington Avenue, 4th Floor Monsey NY United States 10022 Does the person work as senior executive of a DB-recognized regulated entity in the financial industry? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities Is the individual a Politically Exposed Person (PEP)?(if Yes, describe) To the best of your knowledge, is the individual related to an employee of the DB group?(if Family or Friendship, describe ) 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 services)?(if Yes,describe ) Yes No Yes Family No Friendship None Date of Birth: Country of Citizenship: Has client resided outside of his/her country of nationality for 5 years or more? Tax ID / SSN: Position/Title/Rank: If applicable, indicate which bank officers have met the person: Bank Officer Name(s) EFTA01417566 Indicate where and when the client meeting(s) took place: Bank Office: Client Private Domicile: Client Place of Business: Other Location (specify): Date: 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: Business Owner Salary/Earnings Investment Inheritance/Gifts Other: Further Describe Source of Wealth /Detail the history of wealth for each of the sources: (e.g. For trusts, 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($): Estimated Net Worth($): Other Known Financial Institutions: Institution: Institution: Institution: Estimated amount of investable assets($): Amount of assets planned to invest with PWM($): Country: Est. Assets Under Mgt: Country: Country: Est. Assets Under Mgt: Est. Assets Under Mgt: https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 28/43 EFTA01417567 7/15/2019 KYC Print Please indicate the family situation of the individual (marital status, other family members, etc.): https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?- lid=01N30000000D9Di&eid=5003200001EHPpb&ic=lainkToken=VmpFPSxNakF4Tm 29/43 EFTA01417568 7/15/2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summary 3A. Individual Details (for all parties) Individual's Name: Country of Residence: Address of primary residence: Profession/Occupation: Current Employer: Address of employer: Erika Kellerhals - 00000499664 USA 9100 Port of Sale Mall, Ste 15 St. Thomas 00802 United States Attorney Kellerhals Ferguson Kroblin PLLC 9100 Port of Sale Mall, Ste 15 St. Thomas VI United States 00802 Does the person work as senior executive of a DB-recognized regulated entity in the financial industry? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities Is the individual a Politically Exposed Person (PEP)?(if Yes, describe) To the best of your knowledge, is the individual related to an employee of the DB group?(if Family or Friendship, describe ) 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 services)?(if Yes,describe ) Yes No Yes Family No Friendship None Date of Birth: Country of Citizenship: Has client resided outside of his/her country of nationality for 5 years or more? Tax ID / SSN: Position/Title/Rank: If applicable, indicate which bank officers have met the person: Bank Officer Name(s) EFTA01417569 Indicate where and when the client meeting(s) took place: Bank Office: Client Private Domicile: Client Place of Business: Other Location (specify): Date: 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 Bu
ℹ️ Document Details
SHA-256
cf29d08c94dfb145d7f5cb83a28c708dc4a7745cc7e0445fcb6c010b857f30d8
Bates Number
EFTA01417521
Dataset
DataSet-10
Document Type
document
Pages
72

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