EFTA Document EFTA01356694

KYC Print Page 22 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: Russian Federation Country of Citizenship: Russian Federation Address of primary residence: • ussian Federation Has client resided outside of his/her country of nationality for 5 years or more? L yes ITLI No Profession/Occupation: N/A Tax ID / SSN: Current Employer: