Case File
efta-01282873DOJ Data Set 10OtherEFTA01282873
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01282873
Pages
3
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
Deutsche Asset
& Wealth Management
DBTCA Deposit Account Opening Application
Private Wealth PremiumTM
Elite Personal Accounts
O
Checking Acct. #
O
Elite
Acct.
APY
O
Elite
Acct.
APY
O
Certificate of Deposit
Acct.
APY
Term
O DB AG NY Preferred
Certificate of Deposit
Acct. H
APY
Term
Promo term
(013TCA deposit account required,
along with a 08 AG Preferred loins
and Conditional
Private Wealth Premiumm
Internet Banking Services
▪
D8 Private Wealth Online Plus
O Link to Existing Online Relationship
Private Wealth PremiumTM
Elite Business Accounts
O
Checking Acct. If
O
Elite Checking with Interest
Acct. H
APY
O Elite Money Market Deposit
Acct. #
APY_
O Certificate of Deposit
Acct. #
APY
Term
O DB AG NY Preferred
Certificate of Deposit
Acct. PI
APY
Term
Promo term
(DBTCA deposit account required*
along with a 08 AG Preferred Terms
and Conditions)
O Cash Master Sweep Account
Checking Acct. 8
(User/Co. ID Number)
Client Relationship
O Individual Account
▪
Joint Tenants with Right
of Survivorship
O Joint Tenants in Common
C
I
In Trust For/Payable on
Death/As Trustee for
O Trust
D Estate
Private Wealth Premiumna
Banking Services
O
Consumer Debit Card #
O Joint Applicant Debit Card #
1
O
Business Debit Card #
O
Deluxe Checkbook Style #
D Name Only
Name and Address
O
Duplicate Statement
Add,
City
State
Zip Code
O Mailing address (if different)
Name
Addr
City
State
Zip Code
Elite Money Market Deposit
Acct. II
APY
Target Amount
Trigger Amount
O Custody under NY UTMA
D Foundation
D Non-Profit Organization
O
Attorney Trust Escrow
O
Landlord Master Escrow
O
Corporation
O
Limited Liability Company
O Partnership
O
Limited Liability Partnership
CONFIDENTIAL
13-AWM•01131
NAOSOD00014499-1100102434
073959.032613
SDNY_GM _00038465
CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0001289
EFTA_(() I49074
EFTA01282873
Account Tide and Joint Application Information
Jeffrey Epstein
Name of Account Title
(last name, fast name. middle initial) or Rosiness
Social Security Number or Taxpayer ID Number
01..00
Mack Qtr.83
Address
"AInt.thomes
U.S. Virgin Istes00802
C'
usiness Telethons Number
2OtJant1953
Oats of (Jinn
.6 4--
South
Name of Employer
6100 Red Hook Quarter B3
Address
St Thomas
City. State and Zip Code
U.S.1Omin Islay 00802
Notice of Customer Identification Policy
Joint Applicant
(last name, first name, middle initial)
Social Security Number or Taxpayer 10 Number
Address
City. State and Zip Code
Horne Telephone Number
Business Telephone Number
ViTiarzirin
Name of Employer
Address
City. State and Zip Code
Important Information
To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial
institutions to obtain, verify, and record information that identifies each person who establishes an account, investment or
other business relationship with a financial institution. This means that we will ask for your name, address, and other
information that will allow us to identify you. We may also ask to see identifying documents such as a certificate of
formation or good standing (legal entities) or a passport or other photo identification (individuals).
3rd EU Notice
Governmental rules have also broadened the scope of the Bank's obligations to aid in the fight against money laundering
and terrorist financing: these rules call for an active involvement of both asset management firms and their clients. For
new and existing clients we currently have a legal obligation to ask our customers questions regarding their identities,
addresses. source of funds and, if necessary, legal representatives. authorized signatories, beneficial owners or control
Structures and to cdeoct requisite documentation to substantiate the information. Also. enhanced anti.money laundering
requirements require that should any Of the above personal or institutional information change, our clients would be
obliged to immediately notify us of the changefs) and provide us with relevant documentation to verily these changes.
Telephone, Facsimile or Email Instructions
By signing below. you agree that from time to time you may give instructions by telephone, facsimile or email regarding
the above captioned account(s) (delined herein as "Verbal Instructions"). It is understood that the risk of Verbal
Instructions being given by person or persona purported to be you is your . own. Absent the gross negligence or willful
misconduct of Dousche Bank Trust Company Americas (OBTGA). you agree to indemnify and hold harmless MICA for
any claims, losses, expenses, costs dr attorneys' fees resulting from DBTCA's acting upon such misunderstood and
unauthorized Verbal Instructions. You understand that DBTCA may. but shall not be required to, seek verificatinn of your
verbal, facsimile or email instructions by call back. In case of doubt. DBTCA may in its sole discretion refuse to execute
your Verbal Instructions or any pan thereof, without incurring any liability. ()Brea is under no obligetion to execute your
Verbal Instructions to transfer funds or securities to aoy account(s) without written instructions bearing your original
signature.
Joint Account Disclosure
You have opened a joint account with DBTCA and acknowledge receipt of the following information: This deposit and any
additions to the account shell become the property of each owner as joint tenants, and DBTCA may release the entire
account to any owner during the lifetime of all owners. DBTCA may honor checks, orders or withdrawal requests from
any owner during the lifetime of all owners. The Bank may be required by service of legal process to remit funds held in
the joint account to satisfy a judgment entered against, or othel valid deot incurred by, ahy owner bf the account. DBTCA
may honor checks, orders or withdrawal requests from the survivor(s) after the death of any owner(s) and may heat the
account as the sole property of the survivor(s) after the death of any owner(s). Unless DBTCA receives written notice
signed by any owner not to pay or deliver any joint deposit or addition or accrual, DBTCA shall not be liable to any owner
for continuing to honor checks, orders or withdrawal requests from any owner. After the receipt of the notice referred to
in the previous sentence, DBTCA may require the written authorization of any or all joint owners for any further payments
or deliveries.
2
13.AWM-O101
013959.032813
CONFIDENTIAL
SDNY_GM_OOO38466
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DEI-SDNY-0001290
EFTA_OCI I49075
EFTA01282874
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
If you have selected fo receive Internet Banking Services, yoo understand that you will be required to eater into a
separate Internet Banking Services Agreement with OBTCA before you can access the Internet Banking Service.
Acknowledgement of Receipt of Privacy Notice
By signing below, you acknowledoe receipt of DBTCA's Privacy Notice included in the Application Package.
Non-US Individuals: Confirmation of Tax and Compliance Responsibilities.
You confirm that it is your responsibikty to fulfill any tax obligations and any other regulatory reporting duties applicable
to you in any relevant jwisdictions that may arise in connection with assets. income or transactions in your account(s)
and your business relationship with OBTCA.
Non-US Organizations: Confirmation of Tax and Compliance Responsibilities.
You confirm that it is your responsibility to fulfill any tax obligations and any 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), settlor(s),
beneficiary(ies), pertner(s), etc. to enable him/hell them to fulfill any respective tak obligations that may arise for him/her/
them in connection with your business relationship with OBTCA.
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 aed agree to be bound by them. In addition, you awed to notify us immediately of any material change to
the information provided by you on this Application.
You represent and warrant that all of the information provided by you on this Application is accurate_
The Terms and C ndifions for Deposit Acc
are subject to change.
on
Accep
c
y :
-
You ndeistand that
OrdirerriTigisatit
pianos by DBTCA.
Joint Account Holder's Signature
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CONFIDENTIAL
13AWesi.0101
013959.i:02613
SDNY_GM_00038467
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0001291
EFTA_00 I 49076
EFTA01282875
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