belitsche Asset

belitsche Asset ' & Wealth Management u. *O4CI% VAS- • (.0 DBTCA Deposit Account Opening Application Private Wealth Premiumi'm Elite Personal Accounts O Checking Acct. X O Elite Checking with Interest Acct. # APY O Me Money Market Deposit Acct. # APY O Certificate of Deposit Acct. 8 APY Term K OB AG NY Preferred Certificate of Deposit Acct. APY Term Promo term IDEITCA deposit account required. along with a GB AG Preferred Terms and Conditions) Private Wealth PremiumT" Internet Banking Services DB Private Wealth Online Plus Ei Link to Existing Online Relationship /03 oa5- 0 (User/Co. ID Number) Client Relationship O Individual Account O Joint Tenants with Right of Survivorship O Joint Tenants in Common O In Trust For/Payable on Death/As Trustee for O Trust O Estate Private Wealth Premium 714 Elit usineSs Accounts Checkingalc % 6,cst • N 't Si O Elite Checking with Interest Accl. Py fl iElite Money Market Deposit Acct. Egg / 61 w 1 APY O Certificate of Deposit Acct. APY Term O DB AG NY Preferred Certificate of Deposit Acct. N APY Term Promo term (DBTCA deposit account required. alone with a DR AG Preferred Terms and Conditions) O Cash Master Sweep Account Checking Acct. Private Wealth Premiumm Banking Services O Consumer Debit Card O Joint Applicant Debit Card # O Business Debit Card # re<eluxe Checkbook Style // (lot ktrogC O Name Only al Name and Address O Duplicate Statement Add: Crty State Zip Code O Meiling address different) Name Addr City State Zip Code Elite Money Market Deposit Acct. # APY Target Amount Trigger Amount K Custody under NY UTMA O Foundation O Non-Profit Organization O Attorney Trust Escrow Landlord Master Escrow O Corporation 0 Limited Liability Company O Partnership O Limited Liability Partnership is.awraoffn NAOSODUCI015602-000104611 013959 032613 CONFIDENTIAL - PURSUANT TO FED. R. CRI M. P. 6(e) DB-SDNY-0001449 EFTA_00014923 EFTA00165707 Acco 1 Title anddoint Appripati Into tritr _ /w ry 1.---i„,..)51- 4 4c 0., 4.../— tte if 10 !. Xna Name of Account Title Joint Applicant Mast nameC middle31L i hal) or Business " e pest name, first name, middle initial! n Social Security Number ° or Taxpayer ID Number 51C ( !enctice,.) A ViPhtle ' V f-tri Address Si Address itiv foot. Not applicable City7Staiettd Zip Code City, Stale and Zip Code Social Security Number or Taxpayer ID Number Home Telephone Number mess p ne um r Business Telephone Number Dam of Binh Name of Employer Address Oa re of Bins Name of Employer Address Not applicable City. State and Zip Code City. State and Zip Code Notice of Customer Identification Policy Important Information To help the government fight the funding of terrorism and money laundering activities, Federal law requires alt financial institutions to obtain, verify, and record information that identifies each person who establishes an account, investment or other business relationship with a financial institution. This means that wo will ask for your name, address. end other information that will allow us to identify you. We may also ask to see identifying documents such as a certificate of formation or good standing (legal entities) or a passport or other photo identification (individuals,. 3rd EU Notice Governmental rules have also broadened the scope of the Bank's obligadons to aid in the fight against money laundering and terrorist financing: these rules call for an active involvement of both asset management firms and thew clients. For new and existing clients we currently have a legal obligation to ask our customers questions regarding their identities, addresses, source of funds and. if necessary, legal representatives, authorized signatories, beneficial owners or cootiel structures and to collect requisite documentation to substantiate the information. Also, enhanced anti money laundering requirements require that should any of the above personator institutional information Change, our clients would be obliged to immediately notify us of the charges) and provide us with relevant documentation to verify these changes. Telephone, Facsimile or Email Instructions By signing below, you agree that from time to time you may give instructions by telephone, facsimile or email regarding the above captioned accounts) (defined herein as "Verbal Instructions"). It is understood that the risk of Verbal Instructions being given by person tlf persons purported to be you is your own. Absent thogross negligeoce or willful misconduct of Deusche Bank joist Company Americas (DEtTCA), you agree to indemnity and hold harmless OBTCA for any claims, losses, expenses, costs or anorneys' fees resulting from DBTCA's acting upon such misunderstood and unauthorized Vorbaf Instructions. You andetstand that DBTCA may, but shall not be required to, seek verification of your verbal, facsimile or email instructions by call back. In case of doubt. DBTCA may in its sole discretion refuse to execute your Verbal Instructions or any pan thereof, without incurring any liability. DBTCA is under no obligation to execute your Verbal Instructions to transfer funds or securities to any aocount(s) without written instructions bearing your original signature. Joint Account Disclosure You have opened a taint account with DBTCA and acknowledge receipt of the following information: This deposit and any additions to the account shag become the property of each owner as joint tenants. and DBTCA may release the entire account to any owner Cluritg the lifetime of all owners. OBTCA may honor onecks. orders or withdrawal requests from any owner during the lifetime of all owners. The Bank may be required by service of legal process to remit funds held in the Joint account to satisfy a judgment entered against, or other valid debt incurred by, any owner of the account. D8TCA may honor checks, orders or withdrawal requests boos the survivor(s) slier the death of any owner(s) and may treat the account as the sole properly of the survivors) after the death of any owner(s). Unless DBTCA receives written notice signed by any owner not to pay or deliver any feint deposit or addition or accrual. DBTCA shag not be liable to any owner lot continwng to hdnor cheeks, eiders or withdrawal requests from any owner. After the receipt of the notice referred to in the previous sentence, DBTCA may require the written autharirationtof any or all pint owners for any further payments or deliveries. 2 134W/A4);01 013959032613 CONFIDENTIAL — PURSUANT TO FED. R. CRI M. P. 6(e) DB-SDNY-0001450 EFTA_000 14924 EFTA00165708 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 If you have selected to receive Internet Banking Services, you understand that you will be required to enter into a separate Internet Banking Services Agreement wire DBTCA before you can access the Internet Banking Service. Acknowledgement of Receipt of Privacy Notice By signing below, you acknowledge receipt of DBTCA's Privacy Notice included in the Application Package. Non-US Individuals: Confirmation of Tax and Compliance Responsibilities. You confirm that ins 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 responsibiNry to fulfill any tax obligations and any other regulatory reporting duties applicable to it in any relevant jurisdictions that may arise in connection with assets, income or transactions in your accounts) and your business relationship with DBTCA Funhturnorc, 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(N, settlor(s), beraficiary(ies). partner(s), etc. to enable him/her/ them to fulfill any respective tax obligations that may arise for him/hed them in connection with your business relationship with DBTCA. Please complete and attach 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 and agree to be bound by them. In addition, you agree 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 Conditions for Deposit Accounts are subject to change. Acceptance understand that this arta .5 subsea toe ceptance by DBTCA. Cil f eb3 Account tioder's Signature Date Joint Account Holder's Signature Dare ern For Ban q‘l nine. WAiV• IY"BeCiewid_bann . •NiacMc# 11.- • .-as.,• 77,1•IX r 0. 6'40* ntclip,te*WSPEVI&MVWW :hlt atiVw- cite. XatnITX9.. .Araltr;5*XtfiticatNte ixtcryin 71:17'e 7-Cfctits 4" , ! w..:3616:3;276", 16r e 66e rekflOr r fl:?ltary Ofr ell. 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