EFTA Document EFTA01432419

EFTA01432419 EFTA01432420 EFTA01432421 EFTA01432422 Deutsche Bank Wealth Management Business Deposit Account Opening Application 02/09/1999 -TheHazeTrust Account Title Dale of Incorporation _The Haze. Trust Entity/Company Name Taxpayer ID Number (TIN) .61 OO.RecLHQokjQuarter_B3 Mailing Address St, Thomas 0 00802 .... City State Zip 340 7752525 Business Telephone Number 340 775 2525 Business Fax Number Other Number 0 00802 6100 Red Hook Quarter B3 St, Thomas Legal Address (if different from mailing address) City State Zip Client Relationship K Corporation K Foundation Limited Liability Company (LLC) Attorney Escrow Account r* Partnership Landlord Master Escrow Ll Non-Profit Organization / Trust Limited Liability Partnership (LLP) Estates Private Wealth Premium" Deutsche Bank AG NY Branch Accounts DBTCA Accounts EFTA01432423 K Deutsche Bank AG NY Preferred Banking Account Deutsche Bank AG NY Preferred Certificate of Deposit L-i Checking Account Checking with Interest K Money Market Deposit K DBTCA Certificate of Deposit e_j APY Term Promo term (DBTCA deposit account required, along with a DB AG Preferred Terms and Conditions) APY Term Li Cash Master Sweep Account Trigger Amount Target Amount Banking Services K Deluxe Checkbook Debit Cards— Business Debit Card K Name Only i . Name and Address Duplicate Statement Color Style Code Name Internet Banking Services Address K DB Private Wealth Online Plus K Link to existing online relationship: State Zip Code City WM167245 015624.090816 Page 1 of 3 NAOSOD00022695-000180789 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 EFTA01432424 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 oi' 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. 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. Organizations: 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 it in any relevant jurisdictions that may arise in connection with assets, income or transactions in your account(s) and your business relationship with DBTCA. 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), beneficiary(ies), partnerfs), etc., to enable him/hei/them to fulfill any respective tax obligations that may arise for him/her/them in connection with your business relationship with DBTCA. EFTA01432425 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. WM167245 015624.090816 Page 2 of 3 Acceptance You understand that this application is subject to acceptance by DBTCA. (B>- Authorized Signer Authorized Signor Parrenjndyke Print Name Date Print Name Date For Bank Use Only Reviewed by: Signature Name Title Date Accepted by DBTCA: Signature Name Title Date Account numbers: DDA NOW MMDA CD/D BAG WM167245 015624.090816 W-9 Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Form (Rev. December 2014) Department of the Treasury Internal Revenue Service 1 Name (as shown on your income tax return). Name is required on this line; EFTA01432426 do not leave this line blank. The Haze Trust 2 Business name/disregarded entity name, if different from above CM 0> D) 4 Exemptions (codes apply only to certain entities, not individuals: see instructions on page 3): Exempt payee code (if any) Exemption from FATCA reporting code (if any) lAppiles to e000unis mainleinoo oulsida the U.S.) 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: I I Individual/sole proprietor or D C Corporation 0 S Corporation 0 Partnership 0 Trust/estate single-member LLC I I Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) 8 0 .11 Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification of the single-member owner. I I Other (see instructions) . a. 5 Address (number, street, and apt. or suite no.) 6100 Red Hook Quarter B3 Requester's name and address (optional) 0 V) 6 City, state, and ZIP code d> o> CO St, Thomas 0 ,00802 7 List account number(s) here (optional) Taxpayer Identification Number (TIN) Parti Social security number Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I EFTA01432427 instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. or Em loyer identiflcatlon number Part II Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report ail interest or dividends, or (c) the IRS has notified me that I am no ionger subject to backup withholding: and 3. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3. Sign Here Signature of ^ U.S. person Date ^ • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding? on page 2. By signing the filled-out form, you; 1. Certify that the TIN you are giving is correct (or you are waiting for a EFTA01432428 number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income, and 4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting? on page 2 for further information. General Instructions Section references are to the internal Revenue Code unless otherwise noted. Future developments. Information about developments affecting Form W-9 (such as legislation enacted after we release it) Is at www.irs.gov/fw9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following; • Form 1099-INT (interest earned or paid) • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) Form W-9 (Rev. 12-2014) Cat. No. 10231X Deutsche Bank Wealth Management Signature Card Deutsche Bank Trust Company Americas The Haze Trust Account Holder Title Individual Account Number ITF/POD/ATF* Corporate .. Limited Liability Corporation EFTA01432429 /' Other: trust Number of Signatures Required: 1 Partnership ... Joint, with Rights of Survivorship Joint. Tenants in Common Darren Indyke Print Name Signature Print Name Signature Print Name Signature Print Name Signature Date Approved Power of Attorney Specimen Signature ' For ITF/POO/ATF See Supplemental Terms and Conditions Date of Power of Attorney 11111111111111111111111111111111111 NAOS0000022695-000180791 WM167290 006678.010816 EFTA01432430