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efta-efta01356003DOJ Data Set 10Correspondence

EFTA Document EFTA01356003

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DOJ Data Set 10
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efta-efta01356003
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EFTA Disclosure
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KYC flint Page 10 of 22 Onesheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summar 3k Individual Details or all parties) Individual's Name: Erika Kellerhals sinimp. Date of Birth. Country of Residence: USA Country of Citizens! o USA Address of primary residence: Profession/Occupation: Atto-ey Tax D SS4 Current Employer: Kellerhals Ferguson )(goblin PLLC Position/Title/Rank: Address of employer: 9100 Port of Sale Mall. Ste 15 St. Thomas VI United States 00802 Is the individual a Politically Exposed Person (PEP)flif Yes, describe) OYes w ,..4 No To the best of your knowledge, is the individual related to an employee of the DB group?(if Family or Friendship, describe ) OFamily O Friendship !1 .Noee To the best of your knowledge, is the individual party toe non-banking relationship with Deutsche Bank (e.g., external legal counsel. client referral source, supplier of goods or servIces)7(if Yes,describe ) K Yes RI No If applicable, indicate which bank officers have met the person: Indicate where and when the client meeting(s) took place*. Bank Officer Name(s) Bank Office Client Private Domicile: Client Place of Business: Other Location (specify) Date O O O O O O O O O • Wealth Details for this Individual are not filled in, because they are the same as for the following person: 36. Wealth Details (Only for parties requiting source of wealth description as indicated in Section 2) Nature of the Individual's Business: Summarize Source of Wealth: O Busness Owner O SalaryiEarnings OInvestment O Inhentance/Offs Liother Further Describe Source of Wealth (Detail the history of wealth for each of the sources (e.g. For trusts, how did settlor accumulate wealth? For inheritance. how did family accumulate wealth?For business owners. how long in business, how many employees. level o' profitability? Indicate type of business, countries of m jor activities. important business partners.) Estimated Annual Income (E: Estimated amour: of nves:aot assets(S) Estimated Net Worth($)' Amount of assets planned to invest with PWW(S) Other Known Financial Institutions: https://dbforcepb.my .salesforce.com/servlet/servl et. Integration?1 idr.:11N30000000D9Di&e... 1/11/2018 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0041385 CONFIDENTIAL SDNY GM 00187589 EFTA01356003

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NYC DEPARTMENT OF FINANCE OFFICE OF THE CITY REGISTER This page is part of the instrument. The City Register will rely on the information provided by you on this page for purposes of indexing this instrument. The information on this page will control for indexing purposes in the event of any conflict with the rest of the document. 20 1 1 2270073600 1004E0B 2B RECORDING AND ENDORSEMENT COVER PAGE PAGE 1 OF 4 Document ID: 2011122700736001 Document Date: Document Type: DEED Document Page Count: 3 12-23-2011 Preparation Date: 12-28-2011 PRESENTER: TITLEASSOCIATES - PICK-UP/ AGUSTIN AS AGENT FOR STEWART TITLE 825 THIRD AVENUE - SSR-11-01-9136 NEW YORK, NY 10022 RETURN TO: ERIKA ICELLERHALS, ESQ 9100 HAVENSIGHT, PORT OF SALE, SUITE 15/16 ST. THOMAS 00802 VIRGIN ISLANDS, US PROPERTY Borough Block Lot Unit Address MANHATTAN 1386 10 Entire Lot 9 Property Type: DWELLING ONLY - 1 FAMILY DATA EAST 71ST STREET CROSS REFERENCE CRFN or Document ID or Year

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