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efta-01387997DOJ Data Set 10Other

EFTA01387997

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Unknown
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DOJ Data Set 10
Reference
efta-01387997
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1
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0
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summar 30. 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 morel 0 yes J No Professor), Occupat ion. NA Tax D ESN Current Employer: N A Position Tit:e. Rank N A 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 0B-recognised exchange? (Not pplicable for operating entities ales kw/. No Is the individual a Politically Exposed Person (F£P)?(11 Yes, desaibe) N/A 0 Yes sr ..A1 No To the best of your knowledge, lathe individual related to an employee of the DB groupyd Family or Friendship, dewily) NIA 0 Family 0 Friendship P3 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)7(d Yes,deseribe ) N/A ❑0 Yes 10 No 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 (soeciryt Dare o 0 0 0 D 0 0 Li Wealth Details for this individual are not filed ri because they are :he same as for :he following person. 35. Wealth Details (Only for parties retuning source of wea :h oesc-ption as tad 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: 0 Budness Owner 0 Salary/Earnings 0 Other: • Investment LI Inhentance/Gfts CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0091306 SDNY GM_00237490 EFTA01387997

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