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efta-01282927DOJ Data Set 10Other

EFTA01282927

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DOJ Data Set 10
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efta-01282927
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
Deutsche Asset •&Wealth Management /site) ?-000 %l et DBTCA Deposit Account Opening Application Private Wealth PremiumiM Elite Personal Accounts D Checking Acct. a Elite Checking with Interest Acct. APY O Elite Money Market Deposit Acct. II APY O Certificate of Deposit Acct. 8 APY Term O DB AG NY Preferred Certificate of Deposit Acct. ff APY Term Promo term (12•MCA deposit account moulted. along wig,. OB AG Preferred Terms and Conditions) Private Wealth Premium Internet Banking Services Ca/ DB Private Wealth Online Plus Link to Existing Online Relationship Client Relationship K Individual Account O Joint Tenants with Right of Survivorship O Joint Tenants in Common j O In Trust For/Payable on Death/As Trustee toi Trust O Estate Private Wealth Premium " 4 Elite Business Accounts O i e ecing wi 1 nterest Acct N APY Elite M MIK Acct. N APY O Certificate of Deposit Acct. N APY Term O DB AG NY Preferred Certificate of Deposit Acct. I APY Term Promo term (OBTCA de posh account required. along with a 08 AG Preferred Terms and Conditional O Cash Master Sweep Account Checking Acct. If Elite Money Market Deposit Acct. APY Target Amount Trigger Amount Private Wealth Premium TM Banking Services K Consumer Debit Card I O Joint Applicant Debit Card s O Business Debit Card N 12(Deltice CtrZOOk Style # (0 ) 417- ff O Name Only s" Name and Address O Duplicate Statement Add( City State Zip Coda O Mailing address (if different) Name Addr City. State Zip Code K Custody under NY UTMA O Foundation O Non-Profit Organization K Attorney Trust Escrow K Landlord Master Escrow O Corporation I 3 Limited Liability Company O Partnership O Limited Liability Partnership CONFIDENTIAL 13.AWM-0101 NAOSOD00015602-000104611 013959437613 SDNY_GM_00038526 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0001350 EFTA_00149135 EFTA01282927 X3UCIi; and tp rri Appljcatipormation y t fit ,P•51,I4 Ace 'Tr %.5 ritz, .0-ro Wev/2007 Name of Account ?lo / Joint Applicant pa rsYMss (lest name, first name, middle initial) Societ Stzuristz Na.?erArl ict payizr1O5hiu*ribAn Ve-( Social Security Number or Taxpayer ID Number 5-7c- A.C4c,teficaurzsi-Vce— Address Address _pa t. id I I Q A/(—Not applicable City, State anti Zip Code Cot y. State and Zip Code H Date of Birth ome Telephone Number SOS mess Telephone Number Date of Birth Nemec, Employer Name of Employer Address Address Not applicable City. State and Zip Code Cm, State and r' Code Notice of Customer Identification Policy 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, outbound signatories. beneficial owners or control structures and to collect 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 change(s) and provide us with relevant documentation to verify these changes. Telephone, Facsimile or Email Instructions By signing below, you agree that from time to time you may grve instructions by telephone, facsimile or email regarding the above captioned accoundsl (defined herein as "Verbal Instructions"). It is understood that the risk of Verbal Instructions being given by person or persons purported to be you is your own. Absent the gross negligence or willful misconduct of °Mucha Bank Trust Company Americas (DBTCA), you agree to indemnify and hold harmless DBTCA for any claims, losses, expenses, costs or attorneys' fees resulting from OBTCA's acting upon such misunderstood and unauthorized Verbal Instructions. You understand that DBTCA may. but shall not be required to. seek verification of your verbal, facsimile or email instructions by call back In case of doubt. DBTCA may in its sob discretion refuse to execute your Verbal Instructions or any part thereof, without incurring any liability. DBTCA is wider no oblication tb execute your Verbal Instructions to transfer funds or securities to any account(s1 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 felease 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 sennce of legal process to remit funds held in the joint account to satisfy a judgment entered against, or other valid debt incurred by. any owner of the account. DBTCA may honor checks, orders or withdrawal requests from the survivodsl after the death of any owns*, end may treat the account as the sole property of the survivors) 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. OBICA shall ndt 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 1SAWileiCit 013959.037613 SDNY_GM_00038527 CONFIDENTIAL CONFIDENTIAL - PURSUANT TO FED R. CRIM. P. 6(e) DB-SDNY-0001351 EFTA_00I49I36 EFTA01282928 ATM/Debit Service You agree that the retention or use of the ATMFDebit 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 to receive Internet Banking Services, you understand that you will be required to enter into a separate Internet Banking Services Agreement with DBTCA before you can access the IntelInel Banking Service. Acknowledgement of Receipt of Privacy Notice By signing below, you acknowledge 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 responsibility to fulfill any tax obligations and any other regulatory reporting duties 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 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), senlor(s). beneficiary(fes), panner(s), etc. to enable him/hed them to fulfill any respective tax obligations Mat may arise for hirrilherf 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 all of the information provided by you on this Application is accurate. The Terms and Conditions for Deposit Accounts are subject to change. Acceptance You understand that this appecation is subject to acceptance by MICA Joint Account Holder's Signature PerP ,I") 7,...rriaratAnnil! ka -Frtk • hlReviensiiedrby:- r at . OPeWa tit t jeir Date VS> Vi aka.; Date ,ath I4s=dii43/4 - 3igeas _PC r: -t-sre, cs riMP In' 4‘ prinasygiver -4-rantor rt.„.7.544x≤.* 2,, lc • , trattufr. Y; c4: eserN)raNtelpiZT relaft,I5Vt. 6)1 it a- ;ti 'lertar,:,:.ii0h7lrireTl}IIPSIPIRM?YillAtfili cal '-acct,-.4+, -X' -pt, P1.9"/ ray. • .9. v.v.* ,DEnt.A: 4,tatinica.aveNsint rth hirtIV RS/91.44ftt,0U.t.9,74/3' Mar. flic.tian..:!;911;.if.c9.9•49:599....a944(9.4.W.,e4S.• S. 1/4..Ve.W.44 € 4C- &.."1.4"49r .9,' ‘‘ We STirt% n 4 i30.; .4.,t`5S! i.eletAlay ' ‘b*Pirit `11,t garawasagisika grna.-kla.st t • • Faf 13.AW9.1.0101 3 CONFIDENTIAL 013959032813 SDNY_GM_00038528 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0001352 EFTA_00149137 EFTA01282929

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