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efta-01380001DOJ Data Set 10Other

EFTA01380001

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DOJ Data Set 10
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efta-01380001
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
Deutsche Bank Wealth Management Option Agreement and Approval Form Please Complete All Sections Account Number I N4Gfoot868 Account Type ICash - '_.1 Managed Account 0 Discretionary Account Other Account Name 'Jeffrey Epstein . , Account Registration 1 [Individual Nemeth) of persontelotlwr than account owners) authorized to place orders for the account: Account and Owner Information (Provkle requested Information for each account owner (Client). Mach SuPPlenlent to this Agreement necessal4 iHwry Belier, Darren Indyke Name bl2rffrey Epstein Address k.Little Saint James, St Thomas Phone Number I9 40) 776.2625 lEmployer Southern Financial LLC :coney IVIrgIn Islands, US Number of Dependents Marital Stews Birthdam ' • le Single Otretheaa Phone Number r-- 01120/1953 1 Rum ns-zszts Business Address 15100 Red Hook Quarter, 83, St Thomas, Virgin Islands, USVI 00802 lype of Business Finance Present Brokerage Accounts with 3446 I gat_ Does the indlviduet or entity that controls this account have the power to control any other Option Account(*) with Deutsche Bank Securities Inc.? V. Yes H No Ilse& oleos' prokede the account numberfaX see attached list Position 1 [President Years Held Client(s) Financial Information Aeoreemare A99109(46 Annual Income Sources of Ircomo (Approximate) TApproximate Aggregate Net Worth tfit of Account Cvner(s) from Al Sources Less than $60,000 LI $30.000 -S99.999 0 souse - $249,919 U S250,000 - 3499.999 O 3500,000- $999,999 o SI• 000.000 - S2.499,999 $2.504000 - 34.999.999 Ri 55.000.000 and over Selery/Bonus InterestrDividends Other( ernel* Liquid Net Worth O Less than S50.000 o ssesoo- $99,999 O $104000-$249,999 % I O $250,000 - 5499.999 _94 5600,000-3999,999 O 51.000,000- 52.499.999 o SES00,000 - SA.999.999 SS.003.000 and over __j Apra/note Net Vihrth Excluding Principal Residence O Less than $50,000 o $64000- 399,999 O $104000- S249,999 o 3250.000 - 3499.999 0 ssoaoco -5999,999 O sLooaroo -32499.999 o assure -S4,999.999 55.004000 and over 'Deutsche Bank^ moans Deutsche Bade AG and its aff Slated compan,es. Deutsche Bank Wealth Management represents the wealth management activities condor-led by Deutsche Bank AG or ds subs•diarres. Clients are provided Deutsche Bank Wealth Management products or services by one or more legal entities that zee identtreo to clients pursuant to the contract% agreements. oftenng materials ot ether documentation relevant to such products or services &Owns servicesere offered ;Menge) Deutsche Ban< SecuritiesInc- a brokerdealer and registered investment advises which conducts securities zetivites in the United States. Deutsche Bank Securities Inc is a member of CI NRA NYSE and SIPC. Bethune and lexicang services are offered through Deutsche Bar* Trust Company Americas, member FDIC. and eche( members or the Deutsche Bank Gram wM189768 010721.05101B S c ieS awn , c C EMS' Page t of 4 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0078045 CONFIDENTIAL SONY GM_00224229 EFTA01380001

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