EFTA Document EFTA01357587

Investment Experience Investment Type Experience Annual Activity Level (Select one) (Required) Years of Investing None No history of any transactions Limited (1-5 transactions per year) Moderate (6-15 transactions per year) High (Over 15 transactions per year) Equities Options Fixed Income Mutual Funds Exchange Traded Funds (ETFs) Heal Estate Property (excluding Primary Residence) Variable Annuities Alternative Investments (Hedge Funds, Private Equity) Structured Products Foreign Currency 3rd Authorized Party's Personal Information Name: DOB. SSN: Legal Address: City: State: Zip/Postal Code: Country: Country of Citizenship: If not U.S. (check one): O Resident Alien O Non-Resident Alien Employment Status: O Employed K Self-Employed K Retired O Unemployed Occupation and Position: Employer's Name: Employer's Address: City: State: Zip/Postal Code: Length of Employment: Home Phone Number: Business Phone Number: O Homemaker K Student Investment Experience Investment Type Experience Annual Activity Level (Select one) (Required) Years of Investing None No history of any _ transactions Limited (1-5 transactions per year) Moderate (6-15 transactions per year) High (Over 15 transactions per year) Equities Options Fixed Income Mutual Funds Exchange Traded Funds (ETFs) Real Estate Property (excluding Primary Residence) Variable Annuities Alternative Investments (Hedge Funds, Private Equity) Structured Products Foreign Currency Email Address: CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL 12-PWM-0355 011224.062212 DB-SDNY-0044214 SDNY_GM_00190398 EFTA01357587