Case File
efta-01345289DOJ Data Set 10OtherEFTA01345289
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Source
DOJ Data Set 10
Reference
efta-01345289
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
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Deutsche Bank
'
ealth Managernc.nt
Client Risk Program - Affirmation an
C
ANNAn
Account Hol er Name(s):
Account Number(s):
-:alation Guideline
Ultimate Beneficial Owner(s) (UBO), if
different from Account Holder:
This document is designed to assist the Relationship Manager (RM)/Investment Advisor (IA) in reviewing the
certifications provided by the Account Holder, any Controlling Persons and any Ultimate Beneficial Owners as part of the
Client Risk Program.
This form should be completed by the RM / IA and submitted together with the Self-Certification as described in the 'CRP
Certification Form Submission' document.
Before providing the Confirmation below, the following factors should be carefully considered:
1. Was any information in the Self-Certification provided by the Account Holder/UBO contradicted by. or inconsistent with,
information previously provided by the Account Holder/UBO to the RM / IA?
2. Is the RM / IA aware of any recent change in personal circumstances (e.g. domicile. residence, nationality) of the
Account Holder/U(3O without supporting documentation to verify the change having been provided to DB?
If, after considering the factors above (or any other factors or information of which the RM / IA is aware). the RM / IA has
reason to believe the Account Holder/UBO could be engaged in tax evasion, the RM / IA should not provide the
confirmation below and should instead raise the matter with their supervisor.
Relationship Manager/Investment Advisor (RM 1 IA) Affirmation
I confirm that I am not aware of any information that would lead me to conclude that the information provided in the
Self-Certification is incomplete or inaccurate. I understand and acknowledge that if I become aware of any tax compliance
concerns as it relates to the accounts listed above. I will promptly escalate the matter to my supervisor.
474 , /I
ti rri.)
Rospensiblo Rh!
Nam.
Cal
For internal use only
W9.4167634 023496.031516
•
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0031546
CONFIDENTIAL
SDNY_GM_00177730
EFTA01345289
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