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efta-01356718DOJ Data Set 10Other

EFTA01356718

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Unknown
Source
DOJ Data Set 10
Reference
efta-01356718
Pages
1
Persons
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
KYC Print Page 4 of 2) One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summar 3A. Individual Details or all parties) Individual's Name: David W Jelinek - Date of Birth. Country of Residence' Country of Citizenship Address of primary residence- Has client resided outsoe of his/her country of nationality for 5 years or more? O yes .V. No Professon, Occupation. Finance Tax ID; SSN Current Onplayer ESM Management LLC PosItion/TitW Rank: Authorized Signer Address of employer: 262 38TH STREET New York NY United States 10018 Does the person work as senior executive of a 0B-recognized regulated entity in he financial industry? or a entity listed on a 0B-recognised exchange? (Not pplicable for operating entities Oyes ri No is the individual a Politically Exposed Person (PEP)?(11 Yes, describe) O Yes wr ...1 No To the best of your knowledge, lathe individual related to an employee of the DB groupWif Family or Friendship, describe ) [,,,)Family O Friendship Vi 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)?(if Yes,descrthe ) ❑ID Yes 10 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: Client Private Domicile: Giant Place of Business Other Location (specify) Date K O O O O O O !Wealth Details for this individual are not filled in. because they are the same as for the following person: 3B. 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: U Budness Owner O Salary/Earnings O Other: • Investment OInheritance/Gifts https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?lid IN30000000D9Di&... 12/19/2018 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0042723 CONFIDENTIAL SDNY GM_00188907 EFTA01356718

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URLhttps://dbforcepb.my.salesforce.com/servlet/servlet.Integration?lid

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