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efta-01450322DOJ Data Set 10Other

EFTA01450322

Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01450322
Pages
1
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0
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Extracted Text (OCR)

EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
BY SIGNING BELOW CUENT ACKNOWLEDGES THAT: (t) CUBIT HAS RECEIVED, READ AND AGREES TO THE TERMS AND CONDITIONS OF THIS ACCOUNT AGREEMENT, INCLUDING THE APPENDIX WHICH CONTAINS IMPORTANT INFORMATION: AND 121 THE INFORMATION CONTAINED IN THIS ACCOUNT APPLICATION IS ACCURATE. CUE hiT ACKNOWLEDGES THAT THIS ACCOUNT AGREEMENTCONTAINS A PRE•INSPUTE ARBITRATION CLAUSE AT SECTION III, PAGE 5, AND CLIENT AGREES IOUS TE (ALL ACCOUNT AGREEMENT MONATORIES MUST INITIAL) MAL HERE: THE INTERNAL NUE SERVICE DOES NOT REQUIRE CUENTS CONSENT TO ANY PROVISION OF THIS DOCUMENT OTHER THAN THE CERTIFICATION REQUIRED TO A ID BACKUP WITHHOLDING, AND. IF APPLICABLE, THE CERTIFICATION REQUIRED TO ESTABLISH CUENT'S STATUS AS A NON-U.S. PERSON AND OBTAIN A REDUCED RATE OF WITHHOLDING. Important Information for ERISA employee benefit plan clients: U.S.. Department of Labor regulations require DBSI to disclose to a responsible plan fiduciary certain information in connection with the services that ()BSI provides to a plan, to assist the fiduciary in evaluating the reasonableness of DEISI's services and related compensation. The disclosure is available online, at http://wivw.pwm.db.com/smorkasiert/erise..disdosure_pcs.html. By signing below, you acknowledge that you are a fiduciary responsible for the procurement of DBSI's seMces to the plan, you have read the disclosure and you understand the disclosure. Individual or joint account (IF THIS IS A JOINT ACCOUNT. ALL ACCOUNT OWNERS MUST SIGN): CONFIRMATION OF TAX AND COMPLIANCE RESPONSIBILITIES Client acknowledges having sole responsibility to fulfill any tax obligations and any other regulatory reporting duties applicable in any relevant jurisdictions that may arise in connection with assets. Income or transactions In Client's accounts) and business relationship with DBSI. CHECK A BOX BELOW ONLY IF CLIENTS DO NOT WANT JOINT TENANTS WITH RIGHTS OF SURVNORSHIP OR TENANTS BY THE ENTIRETIES. CLIENTS SPECIFY INSTEAD: pTenants In common; or OCommunity Property (for married couples in certain states; each spouse retains 50% interest In the community property upon death of the first spouse). Signature Date Print Name SSN/EIN Signature Date Print Name SSN/EIN Signature Date Print Namo SSN/EIN Collimation, partnerthip,Ovstor other *Sty' CONFIRMATION OF TAX AND COMPLIANCE RESPONSIBILITIES Client aoknordedges hating sole responsibilityto fulfill any tax obligations and any other regulatory repotting duties applicable Min any relevant jurisdictions that manilaIn connection with assets, Income or transactions in Client's accovnt(si and busIntrini relationship With 0851. Furthermore. Client confirms Mardi necessary Information Ito the best of Client's knowledge and capabilities) is made available no Ian than annuellyto the relents Isineffidal ovmenal, settlot(S), beneflciatyhese. premeds), etc. to enable such person:Is) to fulfill any respective tax obligations that may ads. hireuchperSOM4 in Connection with Client's business relationship with DBSI. Namo of Entity J. Epstein Virgin Islands Foundation, Inc Employer ID No iCri Oclic an, Signature of Officer, Partner, Trustee Autherbald Ports ,, Date 940? Print Name/Title PK/ ci914bPs / 91425 1 /isn't Signature of Officer, Penner, Trustee, Authorized Party Date Print Name/Title Signature of Officer. Partner. Trustee. Authorized Party Date Print Name/Title 13-AWM-0196 7 012146.032813 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0105878 CONFIDENTIAL SONY GM_00252082 EFTA01450322

Technical Artifacts (7)

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Email addresses, URLs, phone numbers, and other technical indicators extracted from this document.

SWIFT/BICACCURATE
SWIFT/BICAPPENDIX
SWIFT/BICAPPLICATION
SWIFT/BICARBITRATION
SWIFT/BICCONTAINS
SWIFT/BICINFORMATION
URLhttp://wivw.pwm.db.com/smorkasiert/erise..disdosure_pcs.html

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