Case File
efta-01392646DOJ Data Set 10OtherEFTA01392646
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01392646
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
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ATM/Debit Service
You agree that the retention or use of the ATM/Debit card constitutes acceptance of the terms and conditions of the
Cardholder Agreement contained in the Terms and Conditions of Deposit Accounts.
Internet Banking Service
It you have selected to receive Internet Banking SerAces, yoo understand that you will be required to eater into a
separate %lomat Banking Services Agreement with DBTCA before you can access the Internet Banking Service.
Acknowledgement of Receipt of Privacy Notice
By signing Or low, you acknowledoe receipt of DBTCA's Privacy Notice included in the Application Package.
Non-US Individuals: Confirmation of Tax and Compliance Responsibilities.
You confirm that it is your responsibility to fulfill any tax obligations and any other regulatory reporting duties applicable
to you in any relevant jurisdictions that may arise in connection with assets, income or transactions in your account(s)
and your business relationship with DBTCA.
Non-US Organizations: Confirmation of Tax and Compliance Responsibilities.
You confirm that it is your responsibility to fulfill any tax obligations arid any other regulatory reporting duties applicable
to it in any relevant jurisdictions that may arise in connection with assets, income or transactions In your account(s) and
your business relationship with DBTCA. Furthermore, you confirm that the necessary information (to the best of your
knowledge and capabilities) is made available no less than annually to the relevant beneficial owner(sl, settor(s),
berieficiary(ies). pertnerls), etc. to enable hirn/her/ them to fulfill any respective tat obligations that may arise for himihed
them in connection with your business relationship with DBTCA.
Please complete and attacb separate W-8 or W-9 documentation as applicable.
Terms and Conditions and Representations
By signing below, you acknowledge receipt of the Terms and Conditions for Deposit Accounts attached to this
Application aed agree to be bound by them. In addition, you awed to notify us immediately of any material change to
the information provided by you on this Application.
You represent and warrant that all of the information provided by you on this Application is accurate.
The Terms and C • nditions for Deposit Acco
are subject to change.
Accept
You
Joint Account Holder's Signature
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lance by DBTCA.
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13-AWM.0101
013959.032613
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0097906
SDNY_GM_00244090
EFTA01392646
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