EFTA01460157.pdf

Deutsche Bank Wealth Management Individual Self-Certification Form Deutsche Bank AG and its affiliates (collectively, 'Deutsche Bank') collect certain information, including tax related information, from their clients. Deutsche Bank collects this information to comply with certain local and international regulatory requirements that are designed, among other things, to foster and support a tax compliant environment. Although these requirements are not necessarily imposed by all countries, Deutsche Bank, as a global bank that strives to achieve consistency in its practices among all of its regions, nonetheless requires this information be provided by clients even if not required by regulation of the country where your account is maintained. Accordingly, Deutsche Bank Wealth Management Americas is sending you this three-part Self-Certification to complete. This Self-Certification applies only to Account Holders who are individuals. If you are an Account Holder but you are not an individual (for example, you represent a corporate entity, personal investment company, trust or other entity) and you received this Self-Certification in error, we ask that you contact your Deutsche Bank Relationship Manager so that we can provide you with the appropriate Entity Self-Certification Form for you to complete. As the Account Holder, you are required to state your residency (or residencies) for tax purposes. If you are a tax resident outside the United States, then Deutsche Bank may be required to report the relevant information on this Self-Certification to the appropriate tax authorities. For joint or multiple Account Holders, please complete a separate Self-Certification for each Account Holder. Please complete the sections on page 2 as directed and provide any additional information as may be required. For the purposes of this Self-Certification -Account(s)' includes any accounts currently held in your name at Deutsche Bank, as well as any accounts you open in the future that are held at Deutsche Bank. While Deutsche Bank Wealth Management does not provide tax advice, you may contact your Relationship Manager if you have questions conceming the Self-Certification process. If you have any questions about how to complete this Self- Certification or about how to determine your tax residency status, please contact your tax adviser or local tax authority. WM167633 023495 031516 Page 1 of 2 CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0121181 CONFIDENTIAL SDNY_GM_00267365 EFTA01460157