Text extracted via OCR from the original document. May contain errors from the scanning process.
Form
W-9
Request for Taxpayer
(Rev. August 2013)
Department of the Treasury
Internal Revenue Service
Identification Number and Certification
Name (as shown on your income tax return)
Business name/disregarded entity name, if different from above
Check appropriate box for federal tax classification:
Individual/sole proprietor
Exemptions (see instructions):
C Corporation
S Corporation
Partnership
Trust/estate
Limited liability company. Enter the tax classification (C=C corporation,
S=S corporation, P=partnership) ►
Other (see instructions) ►
Address (number, street, and apt. or suite no.)
City, state, and ZIP code
List account number(s) here (optional)
Part I
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name
given on the "Name" line
to avoid backup withholding. For individuals, this is your social security
number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the Part I
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 chart on page 4 for
guidelines on whose
number to enter.
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 all interest or dividends, or (c) the IRS has notified me
that I am
no longer 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
EFTA01472325
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 ►
General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.
Future developments. The IRS has created a page on IRS.gov for information
about Form W-9, at www.irs.gov/w9. Information about any future developments
affecting Form W-9 (such as legislation enacted after we release it) will be
posted
on that page.
Purpose of Form
A person who is required to file an information return with the IRS must
obtain your
correct taxpayer identification number (TIN) to report, for example, income
paid to
you, payments made to you in settlement of payment card and third party
network
transactions, real estate transactions, mortgage interest you paid,
acquisition or
abandonment of secured property, cancellation of debt, or contributions you
made
to an IRA.
Use Form W-9 only if you are a U.S. person (including a resident alien), to
provide your correct TIN to the person requesting it (the requester) and,
when
applicable, to:
1. Certify that the TIN you are giving is correct (or you are waiting for a
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
Date ►
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.
Note. If you are a U.S. person and a requester gives you a form other than
Form
EFTA01472326
W-9 to request your TIN, you must use the requester's form if it is
substantially
similar to this Form W-9.
Definition of a U.S. person. For federal tax purposes, you are considered a
U.S.
person if you are:
• An individual who is a U.S. citizen or U.S. resident alien,
• A partnership, corporation, company, or association created or organized
in the
United States or under the laws of the United States,
• An estate (other than a foreign estate), or
• A domestic trust (as defined in Regulations section 301.7701-7).
Special rules for partnerships. Partnerships that conduct a trade or
business in
the United States are generally required to pay a withholding tax under
section
1446 on any foreign partners' share of effectively connected taxable income
from
such business. Further, in certain cases where a Form W-9 has not been
received,
the rules under section 1446 require a partnership to presume that a partner
is a
foreign person, and pay the section 1446 withholding tax. Therefore, if you
are a
U.S. person that is a partner in a partnership conducting a trade or
business in the
United States, provide Form W-9 to the partnership to establish your U.S.
status
and avoid section 1446 withholding on your share of partnership income.
Cat. No. 10231X
Form W-9 (Rev. 8-2013)
Social security number
Employer identification number
Exempt payee code (if any)
Exemption from FATCA reporting
code (if any)
Requester's name and address (optional)
Give Form to the
requester. Do not
send to the IRS.
Print or type
See Specific Instructions on page 2.
EFTA01472327
IN WITNESS WHEREOF, the undersigned, by and through its authorized officer,
has caused this instrument to be
executed on the date listed below.
[FOR BUSINESS USERS]
Business Name
Name/Title
Signature
Date
[FOR ALL OTHER USERS]
Account Name
Name/Title
Signature
Date
By
Print Name/Title
Date
By
Print Name/Title
Date
WM145781
23 Deutsche Bank Internet Banking Services Agreement for DB Private Wealth
Online Plus
010198.080714
714
EFTA01472328
Deutsche Asset
& Wealth Management
DB Private Wealth Online Plus Account Opening Application
Client Information
Client/Company Name
Online Contact Name
Title
Address
City
Phone Number
Email address
Accounts and Services (please check services for each account)
Account
Number
Balance &
Activitiy
Reporting
Account
Book
Transfer
Bill Pay
ACH
Wire
Transfer
Positive Pay
(Fees Apply)
Reconciliation
(Fess Apply)
Private Wealth ID: alpha numeric 6-16 char.
State
Zip Code
ACH Daily Limit $
Wire Transfer Daily Limit $
The ACH Daily Limit is the daily aggregate dollar amount of ACH transactions
(payments and
collections) you may send through Private Wealth Online Plus. The Wire
Transfer Daily Limit is the
daily aggregate dollar amount of wire transfers you may transmit through
Private Wealth Online Plus.
Note: By signing below, you acknowledge and agree that Deutsche Bank will
make reasonable efforts to adhere to the ACH Daily Limit and Wire Transfer
Daily Limit set forth herein, but shall have no obligation to do so.
Further, you acknowledge and agree that, in accordance with the terms of the
Internet
Banking Services Agreement, Deutsche Bank may place (and adjust) daily
dollar limits on the amount that may be transferred at any time, and from
time to
time, for any reason or for no reason.
If I have selected to receive Internet Banking Services, I understand that I
will
be required to enter a separate Internet Banking Services Agreement with
EFTA01472329
Deutsche Bank before I can access the Internet Banking Service.
Account Holder's Signature
Print Name
Date
For Office Use Only:
Primary Officer:
Secondary Officer:
Prepared by:
Date:
Approved by
Wealth Advisor:
Note: Access to DB InSight is the recommended portal to DB Private Wealth
Online
Date:
13-AWM-0135 009614.042314
EFTA01472330
Not
- For
- ProfitOrganizationResolution
D
epositAccount
DeutscheBankTrustCompanyAmericas
Secretary of
[a corporation] [an unincorporated association] duly organized and
existing
under the laws of
, 20
, described
herein as "this organization," hereby certify that the following is a
true copy of resolutions adopted by the Board of Directors of this
organization at a meeting duly held, a quorum being present,
on
and that such resolutions are
now in full force and effect:
"RESOLVED, that Deutsche Bank Trust Company Americas, New
York, N. Y. (the "Bank"), is designated a depositary of this
organization for each account of this organization now or
hereafter opened and maintained at the Bank (whether one or
more, the "Account"); and
"FURTHER RESOLVED, that all drafts, checks and other written
instruments or orders for the payment of money drawn (i) against
the Account or (ii) to or otherwise made payable to this
organization shall be signed or endorsed (for transfer or
encashment) by any
of officers):
(insert number)
of the following*: (insert titles but not names
; and
"FURTHER RESOLVED, that the Bank is hereby requested,
authorized and directed to honor all orders for the payment of
money by wire or other electronic means made or issued in this
organization's name on the Account: (i) when transmitted and
delivered to the Bank by telex, cable, facsimile or other
mechanical or electronic transmission; letter or other written
communication; or telephonic or other oral communication; and
(ii) when separately authorized in writing by any
designated in the preceding "RESOLVED" clause and the Bank
shall be entitled to honor and charge the Account for all such
orders which it believes in good faith to be genuine regardless of
by whom or by what means such orders may have been issued.
The authorization provided in this clause shall include, without
limitation, the right to enter into any agreement(s) with the Bank,
from time to time, containing such indemnities in favor of the
Bank as it may require and such other provisions in order to
effectuate the purpose hereof; and
of officer(s)
(insert number)
EFTA01472331
"FURTHER RESOLVED, that the Bank is authorized to place to
the credit of the Account, funds, drafts, checks, credits or other
property by whomever delivered or transmitted to the Bank for
deposit for account of this organization, endorsed with the name
and/or Account number of this organization or other agreedupon
symbol or identifying mark by rubber stamp, facsimile,
mechanical, manual or other signature (and any such
endorsement by whomever affixed shall be the endorsement of
this organization), or otherwise endorsed, or unendorsed,
provided that if any such item shall bear, or be accompanied by,
directions (by whomever made) for deposit to a specific Account,
then such deposit shall be to the credit of such specific Account;
the Bank may at any time refuse any such deposit or credit to the
Account and/or may return by mail or otherwise the whole or any
part of a deposit to this organization; and
"FURTHER RESOLVED, that the Bank is hereby directed to
accept, and/or apply any draft, check or other instrument or order
for the payment of money, or any proceeds thereof, including
any order for the transfer thereof by wire or other electronic
means, drawn, made or issued on such Account or drawn to or
otherwise made payable to this organization (each such payment
order herein an "Order") when signed or endorsed, made or
issued as required by these resolutions without limit as to
amount, without inquiry and without regard to the disposition of
any such item or any proceeds thereof, and the Bank shall not be
liable in connection therewith notwithstanding that such Order:
(i) may be payable or endorsed to the order of a person whose
signature appears thereon or who otherwise made or issued
such Order or of any other officer(s) or agent(s) of this
organization, or (ii) or any proceeds thereof may be used or
disposed of for the personal credit or account of any such person
(s), officer(s) or agent(s) with the Bank or otherwise or in
payment of the individual obligation of any such person(s), officer
(s) or agent(s) to the Bank or otherwise, or (iii) may cause or
increase an overdraft on the Account; and
"FURTHER RESOLVED, that the Account and all transactions
related thereto, the authorities, specifications, agreements and
services herein provided shall also be subject to all other
agreements, rules, regulations and conditions set forth in any
signature card, deposit ticket, passbook, instrument, receipt,
statement of Account and all state and federal laws, rules and
regulations applicable to the subject matter hereof."
I further certify that this organization is operated primarily for
religious, philanthropic, charitable, educational, fraternal or other
similar purposes and is not operated for profit.
I further certify that the following persons hold in this
organization the positions indicated below:
Name
Title
70444 (7/04)
50/PAD ABC 11/01
EFTA01472332
EFTA01472333
(Complete only if doing business under assumed name;
otherwise disregard.)
I further certify that this organization is (1) doing business under
the name of
(Assumed Name)
as shown by the annexed Certificate of the Secretary of State; (2)
the sole owner of the above assumed name; and (3) will be the
owner of each check, draft or other item drawn or made payable
to said assumed name and deposited to the credit of the
Account.
IN WITNESS WHEREOF, I have hereunto subscribed my
signature and affixed the seal of this organization this
day of
, 20
[SEAL]
* If two signatures are desired, with one signature from each of
two groups, strike out the underlined words and insert "by one
from each of the following two groups, respectively;" then list the
groups separately.
If two signatures are desired, but as a signature and
countersignature, with authority limited accordingly, strike out
the underlined words and add "and signed and countersigned by
one from each of the following two groups, respectively;" then
arrange signature and countersignature groups accordingly.
* *
(Secretary)
** If the Secretary conferred by the above resolutions is
authorized to sign alone, the certification of resolutions must be
confirmed below by another officer.
Confirmed:
(Official Title)
70444 (7/04)
50/PAD ABC 11/01
EFTA01472334
Deutsche Asset
& Wealth Management
Signature Card
Deutsche Bank Trust Company Americas
Account Holder Title
Individual
Joint, with Rights
of Survivorship
Signature
Signature
Signature
Signature
Approved
Power of Attorney
Specimen Signature
* For ITF/POD/ATF See Supplemental Terms and Conditions
006678.080913
13-AWM-0359
Account Number
ITF/POD/ATF*
Joint, Tenants
in Common
Corporate
Partnership
Limited Liability
Corporation
Other:
Print Name
Print Name
Print Name
Print Name
Date
Date of Power of Attorney
Number of Signatures
Required:
EFTA01472335
Deutsche Asset
& Wealth Management
Signature Card
Deutsche Bank Trust Company Americas
Account Holder Title
Individual
Joint, with Rights
of Survivorship
Signature
Signature
Signature
Signature
Approved
Power of Attorney
Specimen Signature
* For ITF/POD/ATF See Supplemental Terms and Conditions
006678.080913
13-AWM-0359
Account Number
ITF/POD/ATF*
Joint, Tenants
in Common
Corporate
Partnership
Limited Liability
Corporation
Other:
Print Name
Print Name
Print Name
Print Name
Date
Date of Power of Attorney
Number of Signatures
Required:
66
0789697
Jeffrey Epstein/President
Gratitude America, Ltd
Jeffrey Epstein
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
EFTA01472336
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
212 971 1314
00802
Not applicable
St. Thomas
6100 Red Hook Quarter, B3
1030850
EFTA01472337
Gratitude America, Ltd
Darren Indyke
NAOSOD00018537-000136083
Jeffrey Epstein
Off
Off
Off
Off
1
Off
Off
Off
Off
Gratitude America, Ltd
EFTA01472338