Case File
efta-01298376DOJ Data Set 10OtherEFTA01298376
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01298376
Pages
1
Persons
0
Integrity
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II. Certification of beneficial owner(s)
Persons opening an account on behalf of a legal entity must provide the following information:
a. Name and Title of Natural Person Opening Account
ea. A and Sec fe4r.
b. Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for Which the Accountleing Opened:
So,yi-inenn T7-04 Co
it (Apo 12,4 bstcov
, ,,.r•4K`4;_i-psiiiiriAL.
SE •Tknevv.as..) OS\31 0080)-
e. The following information for each individual, if any, who, directly or indirectly, through any contract, arrangement
understanding, relationship or otherwise, owns 25 percent or more of the equity interests of the legal entity listed above:
Name
Dated BIM
I
Lagar Address
For U.S. Parsons: i rot Non.U.S Wenn:
Social Saville
j (Sec foornow 1 for alternatives
Menu:
i tO Serial St:way hluntooN
iFs:pa
•
e.
1
i
tot 00 ilea t‘ect< ( .6,61 83
,S4-. Tint. s, tY)1/41 I ago).
I !
I
I
I
i"
I I
' For Non.U.S. Persons.
accit;on toe Social Security Number cif a renpon Number with Country of Issuance. an alien identification card number.. or number
and country of 'nuance of any othor government-isSued dxumeot ericeneing natiVitlOty V casidence one txarew a onotocrepn ce similar safeguam snoula
be orovioto.
flf no iritivicwat lneolt this deli:NOVI. POMO write "Not AoplIcable.1
d. The following information for one individual with significant responsibility for managing the legal entity listed above,
such as:
• An executive officer or senior manager (e.g.. Chief Executive Officer, Chief Financial Officer, Chief Operating Officer,
Managing Member, General Partner, President, Vice President Treasurer); or
• Any other individual who regularly performs similar functions.
(If appropriate, an individual listed under section (c) above may also be listed in this section (c)).
'Nana
i Date of Heil
I Legal Address
hlavve.". 4C7,444
I For U.S. Perst‘n
Fty Non.U.S. Pelona:
Social Security
Number
(See footnote I. for alternatival
to Social Secures Nuance)
For Non-U.S. Persons. in addition 10 a Social Security Number or a Passport Number' ..vith Country of Issuance. an alien ieedification add number. or humps,
and codntey cg issuance of any °e'er 90ventrafit-inuta OcCunivit eviclohcito nximmids or rcskianoc and boating a photograph Cr similar safeguard ShOult1
be prOviO*0.
I, '‘.he saCrn - AL att./4
(name of natural person opening the account), hereby certify. to the best of
my knowledge, that the information provided above is complete and correct.
....I...V.1.5y. naittiks •
%viten
Data
ii
h
If
Name (Print):
Iireel 47P,
Legal Entity tclOnUfier notional)
'rile
..
VP
Si 2018 Deutsche Wel% AG All Ogles reservers WM139666 026819.0Si Sle 4 5:511P6r-e- • ean4rined
9-723fit
-Pr On? Corr ontic (R-e So tot* ork_
SDNY_GM_00062724
ignature V
CONFIDENTIAL — PURSUANT TO FED- R.CDN(E I DENTIAL
DB-SDNY-0025549
EFTA_00173232
EFTA01298376
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