EFTA Document EFTA01356692

KYC Print Page 18 of 43 One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summa 3A. Individual Details (for all part es) Individual's Name: Date of Birth: Country of Residence: United States Country of Citizenship: United Kingdom Address of primary residence: Has client resided outside of his/her country of nationality L yes ITLI No for 5 years or more? Profession/Occupation: N/A Tax ID / SSN: Current Employer: N/A Position/Title/Rank: N