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efta-efta01372903DOJ Data Set 10Correspondence

EFTA Document EFTA01372903

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DOJ Data Set 10
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efta-efta01372903
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
7,15.2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summar 3A. Individual Details (for all parties) Individual's Name: Date of Birth: Country of Residence: USA Country of Citizenship: Address of primary residence: Has client resided outside of his,her country of nationality for 5 years or more> yes sr No Profession/Occupation: Tax ID ; SSN: Current Employer: Position/Title/Rank: Address of employer: Does the person work as senior executive of a DB-recognised regulated entity in the financial ndusby> or an entity Voted on a DO-recognised exchange> (Not applicable for operating entities . Yes No 1 Is the individual a Politically Exposed Person (PEP)?(Yres describe) Yes 1 . No To the best of your knowledge, is the individual related to an employee of the DB group/(,Fd~ or Friendship, ~a) ' Family 1....- Friendship 1 None To the best of your knowledge, is the individual party to a non-banking relationship wkh Deutsche Bank (e.g., external legal counsel, client referral source, supplier of goods or services)?(/ Yesdesaibe) ri y45 iitl No If applicable, indicate which bank officers have met the person: Indicate where and when the chent meeting(s) took place: Bank Officer Name(s) Bank Of0ce: Client Private pomkik: Client Place of Business: Other Location (specify): Date: (3 0 U Wealth Details for this Individual are not filled in, because they are the same as for the following person: 38. Wealth Details (Only for pat requiring source of wealth description as indicated h Settron 2) Nature of the Individual's Business: Primary Country of source of wealth/source of Funds> Primary industry of source of Wealth/Source of Funds> Summarize Source of Wealth: . Business Owner Salary/F-amings . Investment • Inheritance/Gifts Other: 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 weakh>For business owners, how long in business, how many employees, level of profitability> Indicate type of business, countries of major activities, important business partners.) Estimated Annual Income(3): Estimated amount of investable assets(f): Estimated Net Worth(;): Amount of assets planned to invest with PWM($): Other Known Financial Institutions: Institution: Country: Est. Assets Under Mgt: Institution: Country: Est. Assets Under Mgt: Institution: Country: Est. Assets Under Mgt: btips:ildblorcepb.my.salesforce.comiseryletservlet Integration>lidn0 I N30000000D9D4exl=5003200001EHPpb&icu 1 &linkToken=VMpFPSxNakF4T 24.43 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0066810 SDNY GM_00212994 EFTA01372903

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