Case File
efta-01387990DOJ Data Set 10OtherEFTA01387990
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01387990
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 Summar
3A. Individual Details 'a ' a. cc': esi
ndividualt Name:
Date of Birth:
Country of Residence
Russan Federation
Country of Citizenship:
Russian Federation
Address of primary
residence-
Begovaya Street 24 Apt 3 Moscow NA Russ an
ceceration
Has client resided outside
of his/her country of
nationality for 5 years or
more?
CI Yes R No
Profession, °coupe; ion
N A
Tax ID: SSN
722993433
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
the financial Industry? or a entity listed on a OB-recognised exchange? (Not
applicable for operating entities
Oyes ri No
is the individual a Politically Exposed Person (PEP)7(i( Yes. describe) N/A
Yes
a -
.4 No
To the best of your knowledge, lathe individual related to an employee of the DB
groupWif Family or Friendship, describe) N/A
I,,,,) 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 Yam/nate ) WA
O vas
10 No
If applicable. indicate which bank officers have met
the person
Indicate where and when the client meeting(s) took place
Bank Officer Narne(s)
Bank Office
Client
Private
Domicile.
Client Place
of Business
Other Location (soecifyi
Dare
o
O
I
O
O
•
D
O
0
nWealth Details for this individual are rot fixed n because they are :he same as for the following person.
38. Wealth Details (Only for parties 'eau., ng source of wea':h descrIption as Ind cated in Section 2)
Nature of the Individual's Business:
Primary Country of source of wealth/source of Funds?
Primary fldustry of source of Wealth/Source of
Funds?
Summarize Source of Wealth:
1.11 Business Owner O Salary/Earnings • Investment O Inhentance/Glts
J Other:
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0091294
SDNY GM_00237478
EFTA01387990
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