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efta-efta01372904DOJ Data Set 10Correspondence

EFTA Document EFTA01372904

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DOJ Data Set 10
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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) Indrvkluars Name: Darren Indyke - Date of Birth: Country of Residence: USA Country of Citizenship: USA Address of primary residence: Has client resided outside of his her country of nationality for 5 years or more> yes 49 No Profession/Occupation: Accountant Tax ID / SSN: Current Employer: Southern Randal LLC Position/Title/Rank: Address of employer: 6100 Red Hook Quarter 83 St Thomas 00802 Does the person work as senior executive of a D6-recognized regulated entity In the financial ndustry, or an entity kited on a DO-recognised exchange' (Not applicable for operating entities ' Yes No I Is the incividual a Politically Exposed Person (PEP)Wirazg dente) Yes I. No To the best of your knowledge, Is the individual related to an employee of the DB groupliFamlY a Friendship, desofbe) ' Family 1....- Friendship itei None To the best of your knowledge, is the individual party to a non-banking relationship with Deutsche Bank (e.g., external legal counsel, client referral source, supplier of goods or serrices)70/ Yesdesolbe) u Yes it No If applicable, indicate which bank officers have met the person: Indicate where and when the tient meeling(s) took place: Bank Officer Name(s) Bank Office: Client Private pomkile: Client Place of Business: Other Location (specify): Date: Paul Morris C3 9/6/2013 LI Wealth Deists for this individual are not filled in, because they are the same as for the following person: 38. Wealth Details (Only for parties requiring source of wealth description as indicated in Secton 2) Nature of the Indonduars 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 wealth'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(S): Estimated amount of investable assets(S): Estimated Net Worth($): Other Known F, aortal Institutions: Amount of asses planned to invest wth PWM(6): Institution: Country: Est. Assets Under Mgt: Institution: Country: Est. Assets Under Mgt: Institution: Country: Est. Assets Under Mgt: httpe://dbforcepb.my.salesforce.comiservietiservlet IntegraborOlid."01N30000000D9D4eid=5003200001EHPpb&ict 18ilinkToken=VmpFPSxNakF4T 26.43 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0066812 SDNY GM_00212996 EFTA01372904

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