EFTA01392801.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 II you have selected to receive Internet Banking Services, you understand that you will be required to enter into a separate Internet Balking Services Agreement yarb DBTCA before you can access the Internet Seeking Service. Acknowledgement of Receipt of Privacy Notice Sy signing below• you acknowledge receipt of DSTCA'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 dblees 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 lax obligations and airy 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(s), settings). beneficiary(ies), panner(s), etc. to enable him/hed them to fulfill any respective tax obligations that may arise for him/hed 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 and agree to be bound by them. In addition, you agree to notify us immediately of any material change to the information provided by you on this Application. You represent and warrant that allot the information provided by you on this Application is accurate. The Terms and Conditions lot Deposit Accounts are subject to change. Acceptance You understand that this application r5 su 'eel to acceptance by DBTCA. 9 /03 Account Holders Signature Date Joint Account Holder's Signature Dale WM( , ril ik la ir:«WrinT h .-AC/1,4Z co. /wrPrN.Wc ., RC'. I s F ,r e$ it b> V' ' ti r, tr , ' ar+ rif-aitt..f•ZCS µ .a . Willi -7dilpi- ngtilePARWX.VOIAMWADTI-VAL ;g_ciarielPSVOM&W.cTitrie„.1412g -rticTtrart,_34Mil ,- kr,d.4 . as .f. C• .-- en't-NItii."495'. .,407.-5.1-Y4.1Y:C-reDISTS.T.itti'4X1a17.41(.44.1"-Pa:.-4:1WaEOW-artil-rf.wPfitf.,v (INV' C" "n" ..c. .2.'.."T al....i..C35frit4-4 fWes " i'l a• "* - ?:;::* Ci-jf-tiN eVf ir elt.t .. vtk. ia,.,,Aidt,a; ,..... Goviii:."14/ “.7vneciOlie v." . "11 i;*. ctane. c.v..14.3, It.:44" 1.4.",'„ ..44..v.. .q i etr: a I. ,.. nin.Ta.‘,..34, „AV.:P:4,.W Ihr , .. 4 i" t Occept :34 -,,..* "I' 1" t pox:r u sca 1 set .3-•,;-ir ;,.. . , *virmwan-t-giceanivaaranwabralia tr-. ,.. ..wsi-e. : Fa ., Ass. .. ......,-.n.:, is ,,.... . 07.-,----Z-4-tfir. na,; si- V *1 .• 4,4 / -7,4 '01. : 4_?,•.;.itp vxyrii ram....fft:11€411e.iir#z7,01....rez0.4....s.a.„,n# 3 ,2,2,./...nm..),.;,-.....,..,,..„„ .„.. ..,,-1. ..ci 54,r-pq mins71 , ,,v44_,,i. tr, c,,-,,,..,„„acts.,,,.1:2„fw.,0,,,::2 ettiayin -,,,,,,„ ,34 .r 0. 2(4- -4, , oy • a IP, nil N22.,a ,,„ ik : ii 6f," • -- e.),V4irs . ,-, itiV :af,?TitZtA r ?;3. :>; 4-;56 ;F:elit ..•.4. 3 themei.•40 f te.0„.aa, c 11". i rsx, 71.6.4.4.1 ah3 tiA.SWW4rii a 14,4?*S-OaS. ECe t•Thtt) ' *7•Xi* - vz‘ ( 643141 ; 415.14110Catga s 3 13.AWM-010) 013959.032613 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0098069 CONFIDENTIAL SDNY_GM_00244253 EFTA01392801