EFTA Document EFTA01392804

ATM/Debit Service You agree that the retention or use of the ATM/Debit card constitutes acceptance of the terms and conditio •s of the Cardholder Agreement contained in the Terms and Conditions of Deposit Accounts. Internet Banking Service II you have selected to receive Internet Banking Services. you understand that you will be required to enter i to a separate Internet Banking Services Agreement with DBTCA before you car access the Internet Banking Sen ce. 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 that it is your responsibility to fulfill any tax obligations and any other regulatory tenoning dutie applicable to you in any relevant jurisdictions that may arise in connection with assets, income or transactions in your ; rcoum(s) and your business relationship with OBTCA. Non-US Organizations: Confirmation of Tax and Compliance Responsibilities. You confirm that it le your responsibility to fulfill any tax obligations and any other regulatory reporting dutito 3pplicable to it in any relevant jurisdictions that may arise in connection with assets, income or transactions in your acc : ont(s) and your business relationship with OBTCA. Furthermore, you confirm that the necessary information (to the bes of your knowledge and capabilities) is made available no less than annually to the relevant beneficial owner(s), serae ls). beneficiary(ies). partner(s). etc. to enable hirriTherl them to fulfill any respective tax obligations that may arise :or himMed them in connection with your business relationship with DBTCA. Please complete and attach separate W-8 or W-9 documentation as applicable. Terms and Conditions and Representations Acceptant( You understand that this appl By signing below, you acknowledge receipt of the Terms and Conditions for Deposit Accounts attached to th t. Application and agree to be bound by them. In addition, you agree to notify us immediately of any material cl mge 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 posit Accounts are sublet to-change. Di) ount Holder's Signature Joint Account Holder's Signature altagneg reizs artgIFSCr [ 1.--3c11-ag ta ;;;:t.Mt-PACIE 4 TCA. 9.hgx.3 Pate Date annarioaratat Wit 474VAKVr+raacrit: bniVna ifrSeic.rtf *V1)kiks,- .4usre igt ittsg,sx Otteg idi crr oir, R4 Vett nfrWr Sh iaraWV al' r0 e 54 In-- 4. eiISS —iitt HVg.11Sfakitriei rs r44v knitryir tat— PtArS*11' isti.:-W4T 141 iptz.nvi-3.3„3t, . inagaraa.. Tinagagli. msrasort •ter,tf,....tt, tczy, r-ctirAfrrar ,.,, „,,, Isce• ...,, :bithrrt ,„%. :.,,,,A".• .,....,1,,,,>00 : 3 13 .WSSCIOI ci”!59.0a2313 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0098072 SDNY_GM_00244256 EFTA01392804