Case File
efta-01356704DOJ Data Set 10OtherEFTA01356704
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01356704
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
KYC Print
Page 34 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:
United States
Country of Citizenship:
Russian Federation
Address of primary residence:
Has client resided outside of
his/her country of nationality
L yes ii-LI No
for 5 years or more?
Profession/Occupation:
N/A
Tax ID / SSN:
Current Employer:
N/A
Position/Title/Rank:
N/A
Address of employer:
N/A
Does the person work as senior executive of a DB-recognized regulated entity in the financial
ndustly? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities O Yes
N°
Is the individual a Politically Exposed Person (PEP)?(if Yes, describe) N/A
K Yes
RI No
To the best of your knowledge, is the individual related to an employee of the DB group?ff
family or Fnendship, describe) N/A
K Family
0 Friendship
E) None
To the best of your knowledge, is the individual party to a non-banking relationship with
Deutsche Bank (e.g., external legal counsel, client referral source, supplier of goods or
services)?0f Yes,deScnbe) N/A
0 Yes
M No
If applicable, indicate which bank officers have met the
person:
Indicate where and when the client meeting(s) took place:
Bank Officer Name(s)
Bank Office:
Oient Private
Domicile:
Client Place of
Business:
Other Location (specify):
LI
0
U
U
0
Li
r1
0
I ,
L._.; Wealth Details for this individual are not filled in, because they are the same as for the following person:
38. Wealth Details (Only for parties requiring source of wealth description as indicated in Section 2)
Nature of the Individual's Business:
Primary Country of source of wealth/source of Funds?
Primary industry of source of Wealth/Source of Funds?
Summarize Source of Wealth:
0 Business Owner OSalary/Earnings 0 Investment 0 Inheritance/Gifts 0 Other:
Further Describe Source of Wealth /Detail the history of wealth for each of the sources: (e.g. For trusts, how did settlor accumulate weakh? For inheritance,
how did family accumulate wealth?For business owners, how long in business, how many employees, level of profitability? Indicate type of business, countries
of major activities, important business partners.)
Estimated Annual Income(;):
Estimated amount of investable assets($):
Imps://dbforcepb.my. salesforce.com/servl et/servl et.Integration7lid-OIN30000000D9Di&eid=5000e0000 I N... 7/10/2019
CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e)
DB-SDNY-0042702
CONFIDENTIAL
SDNY_GM_00188886
EFTA01356704
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