Case File
efta-01387988DOJ Data Set 10OtherEFTA01387988
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01387988
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
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One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summary
30. Individual Details 'or all part es.
Individual's Name:
Date of Birth,
Country of Residence
Country of Ofizensho
Address of primary
residence-
Has client resided out sce
of his/her country of
nationality for 5 years or
Dyes!
.
No
more?
Professor, Occupat ion
N A
Tax ID .' SSN
Current Employer:
N A
Position/Title' Rank
NSA
Address of employer:
N A
Does the person work as senior executive of a DB-recognized regulated entity in
he financial Industry? or an entity listed on a OB-ratogn iced exchange? (Not
pplicable for operating entities
ElYes tri No
Is the individual a Politically Exposed Person (P€P))?(if Yes, describe) N/A
O Yes
..Alr No
To the best of your knowledge, is the individual related to an employee of the DB
groupWit Family or Friendship, describe) NIA
O Family
O Friendship
P1 None
To the best of your knowledge, lathe 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,describe ) NIA
ID Yes
. w" No
4
If applicable, indicate which bank officers have met
the person:
Indicate where and when the client meetings) took place
Bank Officer Name(s)
Bank Office:
Client
Private
Domicile:
Client Place
of Business
Other Location (soecityi
Date
O
K
O
O
O
•
D
O
O
nWealth Details for this individual are rot filed ri because they are the Sate as for the following person.
38. Wealth Details (Only for parties recur, ng source of weaTh oescroticr as rad cated 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:
DBusness Owner O Salary/Earnings • Investment Li Inhentance/Gifts
JOther.
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0091290
SDNY GM_00237474
EFTA01387988
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