EFTA Document EFTA01392809

Atr_ac 1 r hicikter:SSignertere. ( 1 r... d 1 i...Aavit0 •senot.O.4.thoteides:,,sofoina Fair yam, 1/45•14...., ,flz..)..„.;.•,,,v.....,::,.......r ra by: trlova ,rk mvirowpw , Ya f „,. eii, i,e,,,.,,si. issitgs;w• • .„...y.,i4, gale z if,j) a iikt ' : ..; . • i) r s. l...ir ILYA . 3314.1114.4.3Tai...0fat. FdJM EZT20:47danigasaWirs V riliZnilifiThvn.3tWkarta% is-sof kiihVglitga - 1.1 -M -Voi .. ---•-cW.W .....r irj ) Ett 0.7.; .-ca, ..,05i; satVei r tZer sir .kWfrS '‘iere1t 'e'S.Ph caF init: i.t•;-„..a,, azuw*e in‘ .jai frcir. ' . I. frathainreg 3 ATM/Debit Service You agree that the retention or use of the ATM/Debit card constitutes acceptance of the terms and condit ms of the Cardholder Agreement contained in the Terms and Conditions of Deposit Accounts. Internet Banking Service It you have selected to receive Internet Banking Services, yon undo:eland that you will be required to eat( into a separate Internet Banking Services Agreement with DBTCA before you can access the Internet Banking S uvice. Acknowledgement of Receipt of Privacy Notice By signing below, you acknowledge receipt of DBTCA's Privacy Notice included in the Application Packet 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 reporting du:'.es applicable to you in any relevant jurisdictions that may arise in connection with assets. income or transactions in yot r account(s) and your business relationship with DBTCA. Non-US Organizations: Confirmation of Tax and Compliance Responsibililies. You confirm that it is your responsibility to fulfill any tax obligations and any other regulatory reporting du ..es applicable to it in any relevant jurisdictions that may arise in connection with assets, income or transactions in your i :count(s) and your business relationship with DBTCA Furthermore, you confirm that the necessary information (to the t :ist of your knowledge and capabilities) is made available no less than annually to the relevant beneficial owner(s), se' Voris), ben0ftciary(ies), partner(s). etc. to enable him/her/ them to tuff ill any respective tax obligations that may at to for hirn/hert 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 By signing below, you acknowledge receipt of the Terms and Conditions for Deposit Accounts attached tr this Application and agree to be bound by them. In addition, you apes to notify us immediately of any mated!! 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 You understand that this applicat eptance by DBTCA 9/ L th e i Date tieria , ,'"<Sie,ejffir4". An'tarri :At iiidif7gtratTEcti.: .49.tve S.71 t dit>, a lss . Astit . tr. s. 13-AWM-0701 013939 032613 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0098078 SDNY_GM_00244262 EFTA01392809