EFTA Document EFTA01365777

BY SIGNING BELOW CLIENT ACKNOWLEDGES THAT: (1) CLIENT HAS RECEIVED, READ AND AGREES TO THE TERMS AND CONDITIONS OF THIS ACCOUNT AGREEMENT, INCLUDING THE APPENDIX WHICH CONTAINS IMPORTANT INFORMATION; AND (2) THE INFORMATION CONTAINED IN THIS ACCOUNT APPLICATION IS ACCURATE. -... - CLIENT AC EDGES THAT THIS ACCOUNT AGREEMENT CONTAINS A AGREES TO IT RMS (ALL ACCOUNT AGREEMENT SIGNATORIES MUST wrnAu. INFDALHERE• PRE-DISPUTE ARBITRATION CLAUSE AT SECTION III, PAGE 6. AND CLIENT THE INTERNAL EVENUE SERVICE DOES NOT REQUIRE CLIENTS CONSENT TO ANY PROVISION OF THIS DOCUMENT OTHER 11 IAN THE CERTIFICATION REQUIREDTO AVOID BACKUP WITHHOLDING, AND. IF APPLICABLE, THE CERTIFICATION REQUIRED TO ESTABLISH CLIENT'S STATUS AS A NON-U.S. PERSON AND OBTAIN A REDUCED RATE OF WITHHOLDING. Important Information for ERISA employee benefit plan dente: U.S. Department of labor regulations require OBSI to disclose to a responsible plan fiduciary certain information in connection with the services that DBSI provides toe plan. to assist the fiduciary In evaluating the reasonableness of DBSI's services and related compensation. The disclosure Is available online. at http:AWww.pvem.db.comramericasterdedsa dlsolosure_pcsNml. By signing below. you &scenes/dodge that you aro a fiduciary responsible for the procurement of DOSI'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 TM 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 account(s) and business relationship with OBSI. CHECK A BOX BELOW ONLY IF CUENTS DO NOT WANT JOINT TENANTS WITH RIGHTS OF SURVIVORSHIP OR TENANTS BY THE ENTIRETIES. CUENTS SPECIFY INSTEAD: • Tenants in common; or OCommunity Property (for Married couples In certain stales; each spouse retains SOY. Interest In the community property upon death of the that spouse). Signature Date Print Name SSN/EIN Signature Date Print Name SSN/EN Signature Date Print Name SSNrEIN Corporation, partnership, trust or other entity: CONFIRMATION OF TM AND COMPUANCE RESPONSIBILITIES Client acknowledges having sob iesPOnsibilify to fulfill any tax obligations and that may arise In connection with assets, income or transactions In Client's account(s) necessary Information (to the best of Client's knowledge and capabilities) la made betieficiaryfica partnfithi. etc. to enable such Person(s) to fulfill any respective business relationship with DBSI. any other regulatory reporting duties applicable to in any relevant jurisdictions and business relationship with DBSI. Furthermore. Client confirms that the available no kin than annually to the relevant beneficial ownin(s). SOMOIN. tax obligations that may arise for such presents) In connection with Client's Employer ID No. _ Name of Entity Southern Trust Company Inc / Signet.* of Officer. Partner, Trustee. Authorized pr Date t-') (11. Print NamerTmeJeffrey Epstein k w.......„...2 Signature of Officer, Partner. Trustee, Authorized Party ------- Dale Print Name/Title Signature of Officer. Partner. Trustee. Authorized Party Date Pint NameRitle 7 13AWM-01943 012145.032813 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0056872 SDNY_GM 00203056 EFTA01365777