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efta-efta01436009DOJ Data Set 10CorrespondenceEFTA Document EFTA01436009
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EFTA DisclosureText extracted via OCR from the original document. May contain errors from the scanning process.
Structured Products Agreement and Approval Form
Please Complete All Sections
Account Number
Account Name
Account Type
Individual
Other (specify):
NOTE: IRA and ERISA accounts are prohibited from purchasing Structured
Products.
Account and Owner Information: Provide requested information for each
beneficial account owner ("Client"). If more than one
owner exists, the Structured Products Agreement and Approval Supplementary
Form to this Agreement may be required.
Entity Name, or First, Middle, Last Name of Individual or Trustee or Executor
Joint
Trust
Partnership
Limited Liability Company
Corporation
Address
Country
Phone
Number of Dependents
Marital Status
Birthdate — MM/DD/YYYY
Employer
Business Phone
Business Address
Type of Business
Position
Name(s) of person(s) other than account owner(s) authorized to place orders
for the account
Years Held
Client(s) Financial Information
Approximate Aggregate
Annual Income of Account
Owner(s) from All Sources
Less than $50,000
$50,000 - $99,999
$100,000 - $249,999
$250,000 — $499,999
$500,000 — $999,999
$1,000,000 — $2,499,999
$2,500,000 — $4,999,999
$5,000,000 and over
WM179078 SPAA DBSI 011017 083017
Sources of Income
(Approximate)
Salary/Bonus
Interest/Dividends
Other (specify):
EFTA01436009
Approximate Net Worth
Less than $50,000
$50,000 - $99,999
$100,000 - $249,999
$250,000 — $499,999
$500,000 — $999,999
$1,000,000 — $2,499,999
$2,500,000 — $4,999,999
$5,000,000 and over
Approximate Liquid Net
Worth Excluding Principal
Residence
Less than $50,000
$50,000 - $99,999
$100,000 - $249,999
$250,000 — $499,999
$500,000 — $999,999
$1,000,000 — $2,499,999
$2,500,000 — $4,999,999
$5,000,000 and over
Page 1 of 5
DBSF
EFTA01436010
Investment Experience of Account Owner(s)
Year First
Traded
Options
Equities
Fixed Income
Commodities and Futures
Structured Products
OTC Derivatives
Foreign Currency
Alternative Investments
(Hedge Funds, Private Equity)
Investment Objectives for the Client Account
(Select up to two adjacent objectives):
Capital Preservation
Income
Growth
Aggressive Growth
Representations Relating to Qualification of the Client
Check all that apply. At least one category must be checked.
I represent that Client qualifies as an "Accredited Investor" as defined in
Regulation D under the Securities Act of 1933 because
Client is:
a natural person with individual income exceeding $200,000 in each of the
two most recent years or joint income with a spouse
exceeding $300,000 in each of those years and a reasonable expectation of
the same income level in the current year;
a natural person with individual net worth, or joint net worth with a
spouse, over $1,000,000, excluding primary residence;
a trust with assets in excess of $5,000,000, not formed for the specific
purpose of acquiring the securities offered, whose
purchases are directed by a sophisticated person;
a revocable trust that may be amended or revoked at any time by the grantors
and where all of the grantors are
accredited investors;
a charitable organization, corporation or partnership with assets exceeding
$5,000,000;
a business in which all the equity owners are accredited investors;
a bank, savings and loan association, registered broker or dealer, insurance
company, registered investment company,
business development company or licensed small business investment company;
an employee benefit plan, within the meaning of ERISA, if a plan fiduciary
that is a bank, insurance company or registered
investment adviser makes the investment decisions, or if the plan has over
$5,000,000 in total assets or a self-directed plan
with investment decisions made solely by accredited investors;
a plan established and maintained by a state, its political subdivisions or
any agency or instrumentality thereof, for the
benefit of its employees with total assets in excess of $5,000,000; or
a director, executive officer or general partner of the issuer of the
securities being offered.
EFTA01436011
Average # Trades
Per Year
Average Size of
Trades In $
Types of Previous Option
Experience
Covered Call Writing
Purchased Options
Option Spreads
Uncovered Put Writing
Uncovered Call Writing
None
WM179078 SPAA DBSI 011017.083017
Page 2 of 5
EFTA01436012
Representations Relating to Qualification of the Client (Continued)
I represent that Client qualifies as a "Qualified Purchaser" as defined in
the Investment Company Act of 1940, because Client is:
a natural person (including any person who holds a joint, community
property, or other similar shared ownership interest
in an issuer that is excepted under section 3(c)(7) with that person's
qualified purchaser spouse) who owns not less than
$5,000,000 in investments;
any person, acting for its own account or the accounts of other qualified
purchasers, who in the aggregate owns and invests
on a discretionary basis, not less than $25,000,000 in investments;
a company that owns not less than $5,000,000 in investments and that is
owned directly or indirectly by or for 2 or more
natural persons who are related as siblings or spouse (including former
spouses), or direct lineal descendants by birth
or adoption, spouses of such persons, the estates of such persons, or
foundations, charitable organizations, or trusts
established by or for the benefit of such persons; or
a trust that is not covered by any definition above, and that was not formed
for the specific purpose of acquiring the
securities offered, as to which the trustee or other person authorized to
make decisions with respect to the trust, and each
settlor or other person who has contributed assets to the trust, is a person
described in any definitions above.
Client(s) Strategy Requests. Please check as many of the following
strategies ("Structured Products") as may apply. With all
Structured Products, in the event of early liquidation, there may not be a
liquid market, and the investor may experience a loss
due to costs involved with unwinding the investment. Furthermore, investors
are exposed to the credit risk of the issuing entity,
which in the case of a default, may result in a significant, or total, loss
to the investor.
1. Principal Protected Structured Notes and Certificates of Deposit-9096-100%
Principal Protection which may result in lower
returns than a direct investment in the underlying. Investor understands
that principal is protected only if held to maturity
and that FDIC insurance applies only to Market-Linked Certificates of
Deposit up to the statutory limits.
2. Buffered Notes—Partial principal protection (usually protection from the
first 1096-20% decline in the underlying) which serves
as a buffer to loss. Investors participate in the downside, either on a 1-
for-1 or leveraged basis, in the amount the underlying
declines beyond the predetermined buffer level. Upside participation in the
underlying may be leveraged and is sometimes capped.
3. Contingently Protected (including Reverse Convertible and Callable Yield)
Notes—Full Principal Protection only if a pre-set
barrier is not breached. If a barrier is breached, investors would lose the
level of protection and participate in any decline
in the underlying, if any, at maturity. Structures include but are not
limited to those that pay investors a fixed coupon
payment, participation in upside if the underlying performs positively, or
EFTA01436013
both. The investor acknowledges that settlement
at maturity may be in the form of cash or physical delivery of the
underlying.
4. Market Participation Notes and Warrants—Zero principal protection. Full
downside participation. MPNs may be linked to
one or more underlyings in the form of a weighted basket or overlay and may
be customized to offer straight 1 for 1, or
varying degrees of upside participation, leverage or a fixed coupon.
Investors in MPNs seek access to an underlying which
is generally complex and which may be inaccessible to them in the market. DB
and third party proprietary indices are
typically used as an underlying. Warrants may be linked to hedge funds,
mutual funds, basket of funds as well as individual
stocks and may lose full value or all premium paid if the price of the
underlying asset does not rise.
The following representations are applicable for an individual account. If
this is a joint, trust, partnership, limited liability
company, corporate or other type of account, the word "I" in the following
paragraphs shall mean each owner in the case of a
joint account or the authorized signatory making representations on behalf
of the trust, partnership, limited liability company or
other entity in the case of such account type, as the case may be.
I represent that the purchase of Structured Products is suitable for my
account in light of my investment objectives and
experience, financial situation and risk tolerance. I have made my own
decision to utilize Structured Products for my account
based upon my own judgment, adequate information I have independently
obtained (from sources other than Deutsche Bank)
regarding Structured Products and consultation with my own advisors to the
extent I have deemed necessary as to the legal,
regulatory, tax, business, financial, accounting and related aspects of my
purchase of Structured Products. I understand that
Structured Products may contain a derivative component in the form of one or
more embedded options, and that such option(s)
may have the result of reducing the gains or interest income, or increasing
the losses (which may include a loss of principal) on
the Structured Products, whether held to maturity or sold prior to maturity,
to a greater extent than would be the case if the
Structured Products did not contain such a derivative component. I also
understand that Structured Products may lose their
capital preservation features if sold prior to maturity. Finally, I
understand the investment risks associated with Structured
Products, including but not limited to issuer credit risk, market risk and
liquidity risk.
To the extent permitted by applicable law and rules, I authorize Deutsche
Bank to acquire and dispose of Structured Products
for my Account. I acknowledge and agree that when Structured Products are
utilized for my account Deutsche Bank may
(i) charge me fees in addition to the fees I pay Deutsche Bank for advice
under any separate agreement and (ii) receive
remuneration or compensation from the issuers of Structured Products or
EFTA01436014
their affiliates and other sources, including the
receipt of a commission or selling concession as set forth in the related
prospectus or other offering document for each sale of a
Structured Product for which Deutsche Bank acts as a distributor or sales
agent.
WM179078 SPAA DBSI 011017.083017
Page 3 of 5
EFTA01436015
I agree that I will read carefully any prospectus, term sheet and any other
offering document (any such prospectus, term
sheet or offering document, an "Offering Document") that I may receive in
connection with the acquisition of any Structured
Product for my Account, including disclosures in any such Offering Document
describing the fees I may pay in connection with
the Structured Product as well as representations and warranties that I will
be deemed to have made in connection with the
acquisition of the Structured Product.
Qualified Institutional Buyer
I represent that Client qualifies as a "Qualified Institutional Buyer" as
defined below.
(i) Any of the following entities, acting for its own account or the
accounts of other qualified institutional buyers, that in
the aggregate owns and invests on a discretionary basis at least $100
million in securities of issuers that are not affiliated
with the entity:
(A) Corporation, etc. A corporation (other than a bank, savings and loan or
similar institution referred to in (ii) below),
partnership, Massachusetts or similar business trust, organization described
in Section 501(c)(3) of the Internal Revenue
Code, Small Business Development Company licensed by the U.S. Small Business
Administration under Section 301(c) or
(d) of the Small Business Investment Act of 1958, or business development
company as defined in Section 202(a)(22) of
the Investment Advisors Act of 1940; or
(B) Insurance Company. An Insurance Company as defined in Section 2(13) of
the Act; or
(C) ERISA Plan. An employee benefit plan within the meaning of Title I of
the Employee Retirement Income Security Act
of 1974; or
(D) State or Local Plan. A plan established and maintained by a state, its
political subdivisions, or any agency or
instrumentality of a state or its political subdivisions, for the benefit of
its employees; or
(E) Trust Fund. A trust fund, whose trustee is a bank or trust, whose
participants are exclusively plans specified in
subparagraph (C) or (D) above (but not including trust funds having IRAs or
Keogh plans as participants).
(F) Investment Company. An investment company registered under the
Investment Company Act of 1940 or any business
development company as defined in Section 2(a)(48) of that Act; or
(G) Investment Advisor. An investment advisor registered under the
Investment Advisors Act of 1940.
(ii) Bank or Savings and Loan. We are a bank defined in Section 3(a)(2) of
the Act, a savings and loan association or other
institution referenced in Section 3(a)(5)(A) of the Act, or a foreign bank
or savings and loan association or equivalent
institution that in the aggregate owned and invested on a discretionary
basis, for our own account and the accounts of other
persons, at least the amount of securities specified below (not less than
EFTA01436016
$100 million), calculated as provided in Rule 144A,
as of the date specified below and had an audited net worth of at least $25
million as of the end of our most recent fiscal
year. (This paragraph does not include bank commingled funds, except as
noted in (i)(E) above.)
(iii) One of a Family of Investment Companies. We are an investment company
registered under the Investment Company
Act of 1940 that is part of a "family of investment companies", as defined
in Rule 144A, that owned in the aggregate at least
the amount of securities specified below (not less than $100 million),
calculated as provided in Rule 144A, as of the date
specified below.
(iv) We are a dealer registered under Section 15 of the Securities Exchange
Act of 1934, and we are one of the following.
(A) Dealer/QIB. We owned or invested on a discretionary basis, for our own
account and the accounts of other persons,
at least the amount of securities specified below (not less than $10
million), calculated as provided in Rule 144A, as of the
date specified below.
(B) Dealer/Riskless Principal or Agent. We are acting either on a riskless
principal basis for simultaneous resale to a
qualified institutional buyer or as agent for one or more qualified
institutional buyers.
(v) Entity owned by Qualified Buyers. We are an entity, all of the equity
owners of which are qualified institutional buyers
(each satisfying one of (i) through (iv) above including as applicable the
$100 million test).
In calculating the amount of securities owned or invested: (a) repurchase
agreements, securities owned but subject to
repurchase agreements, swaps, bank deposit instruments, loan participations,
securities of affiliates and dealers' unsold
allotments are excluded; and (b) securities are valued at cost, except that
they may be valued at market if they are reported
in financial statements at market and no current cost information is
published.
WM179078 SPAA DBSI 011017.083017
Page 4 of 5
EFTA01436017
By signing below, I hereby confirm that the representations made in this
Structured Products Agreement and Approval Form
are true to the best of my knowledge.
Client signature block:*
Title of Account
Signature
Name
Date
Signature
Name
Date
The following signature block should be used for a Trust, Partnership,
Limited Liability Company or Corporate client.
*If this is a joint account, all joint account holders must sign.
Title of Account
Signature
Name
Date
Title
If this is a trust account check as appropriate
For Deutsche Bank Office Use Only
Investment Specialist Signature
Print Investment Specialist Name
Manager Approval Signature
Print Manager Name
Date
Trustee
Co-Trustee
Date
Please submit all completed and fully executed forms to Compliance via
NetX360.
"Deutsche Bank" means Deutsche Bank AG and its affiliated companies.
Deutsche Bank Wealth Management represents the
wealth management activities conducted by Deutsche Bank AG or its
subsidiaries. Brokerage services are offered through
Deutsche Bank Securities Inc., a broker-dealer and registered investment
adviser, which conducts investment banking and
securities activities in the United States. Deutsche Bank Securities Inc. is
a member of FINRA, NYSE and SIPC.
0 2017 Deutsche Bank AG. All rights reserved. WM179078 SPAA DBSI
011017.083017
EFTA01436018
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