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efta-efta01392789DOJ Data Set 10CorrespondenceEFTA Document EFTA01392789
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DOJ Data Set 10
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efta-efta01392789
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ATM/Debit Service
You agree that the retention or use of the ATM/Debit card constitutes acceptance of the terms and conditions of the
Cardholder Agreement contained in the Terms and Conditions of Deposit Accounts.
Internet Banking Service
If you have selected to receive Internet Banking Services, you understand that you will be required to enter into a
separate Internet Bonking Services Agreement wit° DBTCA before you can access the Internet Banking Service.
Acknowledgement of Receipt of Privacy Notice
By signing below, you acknowledge receipt of DBTCA's Privacy Notice included in the Application Package.
Non-US Individuals: Confirmation of Tax and Compliance Responsibilities.
You confirm chat it is your responsibility to fulfill any tax obligations and any other regulatory reporting duties applicable
to you in any relevant jurisdictions that may arise in connection with assets, income or transactions in your account(s)
and your business relationship with OBTCA.
Non-US Organizations: Confirmation of Tax and Compliance Responsibilities.
You confirm that it is your responsibirgy to fulfill any tax obligations and any other regulatory reporting duties applicable
to it in any relevant jurisdictions that may arise in connection with assets, income or transactions in your account(s) and
your business relationship with OBTCA. Furthermore, you confirm that the necessary information (to the best of your
knowledge and capabilities) is made available no less than annually to the relevant beneficial owner(s). settlor(s),
beneficiarylies), partner(s), etc. to enable him/het/ them to fulfill any respective tax obligations that may arise for him/her/
them in connection with your business relationship with DBTCA.
Please complete and attach separate W-8 or W9 documentation as applicable.
Terms and Conditions and Representations
By signing below, you acknowledge receipt of the Terms and Conditions for Deposit Accounts attached to this
Application and agree to be bound by them. In addition, you agree to notify us immediately of any material change to
the information provided by you on this Application.
You represent and warrant that all of the information provided by you on this Application is accurate.
The Terms and Conditions for Deposit Accounts are subject to change.
Acceptance
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understand that this arm
Account Nocer's Signature
subject to a mance by DBTCA.
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013959.037513
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0098057
SDNY_GM_00244241
EFTA01392789
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