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efta-efta01416094DOJ Data Set 10Correspondence

EFTA Document EFTA01416094

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DOJ Data Set 10
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efta-efta01416094
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
Individual Deposit Account Opening Application Account Title Name of Applicant (last name, first name, middle initial) Social Security Number or Taxpayer ID Number (TIN) Mailing Address City Home Telephone Number State Zip Code Business Telephone Number Legal Address (if different from mailing address) City Client Relationship Individual Account Private Wealth PremiumTM DBTCA Accounts Checking Account Checking with Interest (Now) Money Market Deposit DBTCA Certificate of Deposit APY Term Cash Master Sweep Account Target Amount Banking Services Deluxe Checkbook Name Only Style Code Trigger Amount State Zip Code Date of Birth Joint Applicant (last name, first name, middle initial) Social Security Number or Taxpayer ID Number (TIN) Mailing Address City Home Telephone Number State Zip Code Business Telephone Number Legal Address (if different from mailing address) City State Zip Code Date of Birth In Trust For/Payable on Death/As Trustee for Joint Tenants with Rights of Survivorship Joint Tenants in Common EFTA01416094 Custody under NY UTMA Deutsche Bank AG NY Branch Accounts Deutsche Bank AG NY Preferred Certificate of Deposit Deutsche Bank AG NY Preferred Banking Account APY Term Promo term (DBTCA deposit account required, along with a DB AG Preferred Terms and Conditions) Debit Cards Name and Address Color Internet Banking Services DB Private Wealth Online Plus Link to existing online relationship: Name Address City Consumer Debit Card Duplicate Statement Joint Applicant Debit Card State Zip Code WM167246 015624.092017 Page 1 of 3 EFTA01416095 Notice of Customer Identification Policy Important Information To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify and record information that identifies each person who establishes an account, investment or other business relationship with a financial institution. This means that we will ask for your name, address and other information that will allow us to identify you. We may also ask to see identifying documents such as a certificate of formation or good standing (legal entities) or a passport or other photo identification (individuals). Information Sharing You authorize Deutsche Bank to share information about you and your Account as set forth in our Privacy Policy, including any disclosures that (1) Deutsche Bank believes are required by applicable law and regulations that apply to Deutsche Bank or others, including disclosure of information about you and your Account to any government agency or self-regulatory body on request, (2) is necessary or appropriate in connection with Deutsche Bank's provision of services under this Agreement, or (3) is requested by a financial institution, financial intermediary, or other third party in order to assist such person with compliance with law applicable to such person in connection with services provided to you or on your behalf. 3rd EU Notice Governmental rules have also broadened the scope of the Bank's obligations to aid in the fight against money laundering and terrorist financing; these rules call for an active involvement of both asset management firms and their clients. For new and existing clients we currently have a legal obligation to ask our customers questions regarding their identities, addresses, source of funds and, if necessary, legal representatives, authorized signatories, beneficial owners or control structures and to collect requisite documentation to substantiate the information. Also, enhanced anti-money laundering requirements require that should any of the above personal or institutional information change, our clients would be obliged to immediately notify us of the change(s) and provide us with relevant documentation to verify these changes. Joint Account Disclosure You have opened a joint account with DBTCA and acknowledge receipt of the following information: This deposit and any additions to the account shall become the property of each owner as joint tenants, and DBTCA may release the entire account to any owner during the lifetime of all owners. DBTCA may honor checks, orders or withdrawal requests from any owner during the lifetime of all owners. The Bank may be required by service of legal process to remit funds held in the joint account to satisfy a judgment entered against, or other valid debt incurred by any owner of the account. DBTCA may honor checks, orders or EFTA01416096 withdrawal requests from the survivor(s) after the death of any owner(s). Unless DBTCA receives written notice signed by any owner not to pay or deliver any joint deposit or addition or accrual, DBTCA shall not be liable to any owner for continuing to honor checks, orders or withdrawal requests from any owner. After the receipt of the notice referred to in the previous sentence, DBTCA may require the written authorization of any or all joint owners for any further payments or deliveries. 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 Banking Services Agreement with 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-U.S. Individuals: Confirmation of Tax and Compliance Responsibilities You confirm that 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 DBTCA. WM167246 015624.092017 Page 2 of 3 EFTA01416097 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 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 You understand that this application is subject to acceptance by DBTCA. Account Holder's Signature Print Name Date For Bank Use Only Reviewed by: Signature Name Title Date Accepted by DBTCA: Signature Name Title Date Account numbers: DDA MMDA NOW CD/DBAG Joint Account Holder's Signature Print Name Date WM167246 015625.092017 EFTA01416098

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