Case File
efta-01372814DOJ Data Set 10OtherEFTA01372814
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01372814
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
7 5 2019
1\YCi Punt
One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownersh
Su ram a r
3A. Individual Details (for all parties)
Individual's Name:
Date of Birth:
Country of Residence:
Country of Citizenship:
Address of primary residence:
Has client resided outside of
his/her country of nationality
for 5 years or more?
Yes if No
Profession/Occupation:
N/A
Tax ID / SSN:
Current Employer:
N/A
Posibon/Teleffiank:
N/A
Address of employer:
NA
Does the person work as senior executive of a 0B-recognized regulated entity in the financial
ndustry? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities
A
'
Yes
No
Is the individual a Politically Exposed Person (PEP)?(( Yes, desert e) N/A
Yes
I No
To the best of your knowledge, is the individual related to an employee of the DB group?(/
Familyor Afendshlp, describe) N/A
,
Family
Friendship
A 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 Ya,desaibe) N/A
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:
Client Placed
Business:
Other Location (specify):
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 Indrviduars Business:
Primary Country of source of wealth/source af Funds?
Primary industry d source of Wealth/Source of Funds?
Business
Summarize Source of Wealth:
Owner
Salary/Earnings -... Investment 1...i Inheritance/Gfts
Other:
Further Describe
did family accumulate
activities, important
Estimated Annual
Source of Wealth /Detail the history of wealth for each of the sources: (e.g. Fa Mists, how did settler accumulate wealth? For inhentance, how
wealth7For business owners, hew long in business, how many employees, level of profitability? Indicate type of business, countries of major
business partners.)
Income($):
Estimated amount of investable assets(;):
Estimated Net Worth(f):
Amount of assets planned to invest with PWM(S):
Other Known Financial Institutions:
Institution:
Est. Assets Under Mgt:
Institution:
Est. Assets Under Mgt:
Institution:
Est. Assets Under Mgt:
https://dblorcepb.my.salesforce.comiserviet/seivletIntegration?lid=01N30000000D9DiSeido5000e00001NOBxm&ic= SiiinkTokeneVmpFPSxNakEd.
2042
CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0066698
SDNY GM_00212882
EFTA01372814
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