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efta-efta00169183DOJ Data Set 9Other

STATE STREET

Date
Unknown
Source
DOJ Data Set 9
Reference
EFTA 00169183
Pages
6
Persons
3
Integrity
No Hash Available

Summary

r' -s A‘` STATE STREET for {yr eythr try You IIPVC,I Wealth Manager Services Custody New Account Opening Form Deutsche Bank Private Wealth Management Account 0 External Custody Date Opened 0 Branch 0 State Domicile Acct Legal Name Next Fiscal 0 Account MIA Type Ed Acct Short/Long Name Enter Name for Sorting: 8701 PERSONAL CUSTODY Account Record O Is Owner a US Tax Payer? O Federal Tax ID (SSN/TIN/EIN) JEFFREY EPSTEIN JEFFREY EPSTEIN 4/10/2014 38: DB NY DOMESTIC - CUSTODY ACCT [E214730 54 U.S. Virgin Islands 0 Administrative Law 32 New York JEFFREY EPSTEIN 12/31 of the current year OR If ERISA Account Enter Plan Year End For Client Service Use Only Tax Prep Service 1 Tax Servicer 2 Production Group 5 OCountry of Residency 0 Acquired by 0 Account Capacity Fee Agrmt Date 0 Group Code 0 Team Code 0 Base Currency 209 United States 20 CUSTODIAN 4/10/14 0 Date of Agreement 4/9/14 0 Date of Apptment 4/9/14 1 DEUTSCHE BANK TR CO AMERICAS 5

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Extracted Text (OCR)

EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
r' -s A‘` STATE STREET for {yr eythr try You IIPVC,I Wealth Manager Services Custody New Account Opening Form Deutsche Bank Private Wealth Management Account 0 External Custody Date Opened 0 Branch 0 State Domicile Acct Legal Name Next Fiscal 0 Account MIA Type Ed Acct Short/Long Name Enter Name for Sorting: 8701 PERSONAL CUSTODY Account Record O Is Owner a US Tax Payer? O Federal Tax ID (SSN/TIN/EIN) JEFFREY EPSTEIN JEFFREY EPSTEIN 4/10/2014 38: DB NY DOMESTIC - CUSTODY ACCT [E214730 54 U.S. Virgin Islands 0 Administrative Law 32 New York JEFFREY EPSTEIN 12/31 of the current year OR If ERISA Account Enter Plan Year End For Client Service Use Only Tax Prep Service 1 Tax Servicer 2 Production Group 5 OCountry of Residency 0 Acquired by 0 Account Capacity Fee Agrmt Date 0 Group Code 0 Team Code 0 Base Currency 209 United States 20 CUSTODIAN 4/10/14 0 Date of Agreement 4/9/14 0 Date of Apptment 4/9/14 1 DEUTSCHE BANK TR CO AMERICAS 5 DOMESTIC CUSTODY 22 US DOLLAR 0 Premium Tax Service Client? O If an ERISA Account is 5500 Reporting Required? 0 Is account owner a tax exempt recipient? 0 Is this an IRA Account? 0 US Tax Class 0 Country Situs 0 State Situs Valid Forms W-9 W-8 Form 1001 Yes No No No 1 US RESIDENT (TAX DUTY) 209 United States 54 U.S. Virgin Islands Rf Status 2 certified 0 Start Date 4/10/2014 (mmiddryyyy) (minfdd/yyyy) (mmtddiyyyy) Treaty Eligible Field 8 Special Withholding Instruction field should only be used for NRA clients submitting W-8Ben forms Treaty Eligible? I No Withholding Special Instructions if Not Using Treaty Eligible Rates CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) aariAbbil8566 EFTA_000 19436 EFTA00169183 Tax Record Address The following address must be added to Global Plus for the official mailing address of the client. If the account owner is a non US taxpayer, enter the address to which the 1099, 1042 or other mailings should be sent. For US taxpayers this may or may not be the same as the owner affiliation address. 0 Client Name Et Street Number 16100 0 City 0 Zip Code 0 IRS Control Name JEFFREY E. EPSTEIN I Street Name Red Hook Quarter, B3 St. Thomas 0 State 0 Country 54 U.S. Virgin Islands 00802 209 United States Affiliation - Owner If owner has an existing client record on Global Plus select Yes in the option below and provide the existing Internal client #. No other Information Is required. If No Is selected owner Information will populate based on tax record information provided. This address information below should reflect the legal/permanent address of the account owner. May be different than mailing address above. 0 Is the owner an existing client record on Global Plus No If new client complete the appropriate information for the owner affiliation: First Name Individual Client Name Name Extension Field or Corporate Name Street # Address Line 2 Mailing Info City Zip Code Name Type Date of Birth Internal Client It Client Title Last Name JEFFREY IEPSTEIN 6100 1 Street Name Red Hook Quarter, 83 St. Thomas State Country SSN or TIN 54 U.S. Virgin Islands 00802 I 209 United States 7 individual Mandatory for IRA Account 0 Select Yes to also use this owner for the following account affiliation types. These are mandatory affiliation setups except for Daily Advice Recipient. If not the owner, complete the additional affiliation setup section. These affiliations types will be setup using the tax record address/mailing address. If that address should not be used select No here and setup in the affiliation section. Yes Yes N 0 Affiliation Type Client/EE Number Affiliation Type Client/EE Number 0 Affiliation Type Client/EE Number 0 Affiliation Type Client/EE Number 0 Affiliation Type Client/EE Number If Daily Advice is to be setup, select which type: 56 - Proxy Voter 137 TAX LETTER RECIPIENT 1042S Recipient (applicable to non-domestic accounts only) 152 - Corporate Action Representative Arthur Tendler EMP # 136 - Advice Recipient #N/A 200 - Strategic Wealth Advisor Paul Morris EMP# 228 - Custody Officer Arthur Tendler EMP # 2 - Investment Officer Arthur Tendler EMP # 4 - Account Assistant Katy cheng EMP# CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) 9S-1&567 EFTA_000 19437 EFTA00169184 0 Affiliation Type Client/EE Number 23 - Tax Officer State Street [E:TAXST] Affiliation Type Client/EE Number Affiliation Type Client/EE Number Affiliation Type Client/EE Number Affiliation Type Client/EE Number Currency Type of Portfolio Portfolio Name Att. Portfolio # Type of Portfolio Portfolio Name Alt. Portfolio # Date Opened Capacity Code 0 Investment Authority 0 Investment Objective 0 Voting Authority 0 Taxlot Sale Method Setup Sweep 0 Sweep Strategy 218 - Employee Account 260 - Interested Party 270 Hirtle Callahan Affiliation IMandatory if opening a Hirtle Account 22 USD US DOLLAR Principal JEFFREY EPSTEIN CUSTODY USD . USD P 199 N/A JEFFREY EPSTEIN CUSTODY USD . USD N 199 4/10/2014 21:21 20 CUSTODIAN 6 NO RESPONSIBILITY 199 - CUSTODY 2 CUSTOMER VOTES 4 highest cost (maximum loss) Yes Acct Code Exten 199 If #1 selected, do not add Proxy affiliation 143 - DWS GOVT CASH FUND [999010GC11 Affiliation Adds Affiliation Type 1251 MUTUAL FUND REPORT RECIPIENT Is the affiliation an existing client record on Global Plus INO Ilnternal Client # If new client complete the appropriate information for the owner affiliation: Individual Client Name Name Extension Field or Corporate Name Street # Address Line 1 Mailing Info City Zip Code Name Type Date of Birth Branch Identify any other affiliati client may be on this acc Fist Name I SAME AS OWNER I Street Namel I State I Country SSN Mandatory for IRA Account n types this ura: 38: DB NY DOMESTIC - CUSTODY ACCT (B214730] 231 MUTUAL FUND PROXY RECIPIENT 252 CORPORATE ACTION RECIPIENT Client Title Last Name CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) tiMUNa58568 EFTA_00019438 EFTA00169185 Affiliation Adds Affiliation Type Is the affiliation an existing client record on Global Plus I No 'Internal Client # If new client complete the appropriate information for the owner affiliation: Individual Client Name Name Extension Field or Corporate Name Street # Address Line 1 City Zip Code Name Type Date of Birth Branch Identify any other affiliation types this client may be on this account: Fist Name Client Trtle Last Name I Street Name I I State Country SSN Mandatory for IRA Account Affiliation Adds Affiliation Type Is the affiliation an existing client record on Global Plus I No !Internal Client it If new client complete the appropriate information for the owner affiliation: Individual Client Name Name Extension Field or Corporate Name Street # Address Line 1 Mailing Info City Zip Code Name Type Date of Birth Branch Identify any other affiliate client may be on this acc Affiliation Type Is the affiliation an existing client record on Global Plus Fist Name I I Street Namel 'State I Country SSN Mandatory for IRA Account n types this tint: Affiliation Adds Client Title Last Name If new client complete the appropriate information for the owner affiliation: Individual Client Name Name Extension Field or Corporate Name Street # Address Line 1 Mailing Info City Zip Code Name Type Fist Name 'Internal Client # I Client Title Last Name (Langer Street Namel State Country SSN CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) A9X‘1-bbg569 EFTA_000 19439 EFTA00169186 Date of Birth Branch Identify any other affiliation types this client may be on this account: Mandat • for IRA Account Affiliation Type Is the affiliation an existing client record on Global Plus If new client complete the appropriate information for the owner affiliation: Fist Name Individual Client Name Name Extension Field or Corporate Name Street # Address Line 1 Mailing Info City Zip Code Name Type Date of Birth Branch Identify any other affiliati client may be on this aco Internal Client Client Title Last Name I Street Name' I State I Country SSN Mandatory for IRA Account n types this tint: i Affiliation Adds Affiliation Type Is the affiliation an existing client record on Global Plus ntemal Client # If new client complete the appropriate information for the owner affiliation: Client Title Fist Name Last Name Individual Client Name Name Extension Field or Corporate Name Street # Address Line 1 Mailing Info City Zip Code Name Type Date of Birth Branch Identify any other affiliation types this client may be on this account: Street Name I I State Country SSN Mandatory for IRA Account CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) DMUTIa0570 EFTA_000 19440 EFTA00169187 Affiliation Adds Affiliation Type Is the affiliation an existing client record on Global Plus If new client complete the appropriate information for the owner affiliation. Fist Name Individual Client Name Name Extension Field or Corporate Name Street # Address Line 1 Mailing Info City Zip Code Name Type Date of Birth nternal Client Client Title Last Name Street Name State Country SSN Mandatory for IRA Account Branch Identify any other affiliation types this client may be on this account: PRASHANT MAHENDRU Name REVIEWED By mahpras at 11:57 am, Apr 10, 2014., DHRUV YADAV Name APPROVED 1/4By yadadhr at 9:25 pm, Apr 10, 2014 4/10/2014 Date 4/10/2014 Date CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) tiDWW-1&571 EFTA_00019441 EFTA00169188

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