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One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summa
3A. Individual Details (for all parties)
Individual's Name:
Date of Birth:
Country of Residence:
USA
Country of Citizenship:
USA
Address of primary
residence:
Livingston
07039 United States
Has client resided
of his/her
on
country of nationality for
5 years or more?
O Yes iA No
Profession/Occupation:
Lawyer
Tax ID / SSN:
Current Employer:
Southern Financial LLC
Position/lide/Ftank:
Address of employer:
575 Lexington Ave, 4th R Livingston NY United States 10022
Does the person work as senior executive of a DB-recognized regulated entity
in the financial industry? (Not applicable for operating entities)
D yin g No
Is the individual a Politically Exposed Person (PEP)?(if Yes, describe)
O Yes
No
To the best of your knowledge, is the individual related to an employee of the
DB group7pf Family or FnendshiA describe )
O Family
O Friendship
gll None
To the best of your knowledge, is the individual party to a non-banking
relationship with Deutsche Bank (e.g., external legal counsel, client referral
source, supplier of goods or services)?(if Yesdescnbe)
O Yes
WI No
If applicable, indicate which bank officers have met
the person:
Indicate where and when the client meeting(s) took place:
Bank Officer Name(s)
Bank Office:
Client
Private
Domicile:
Client Place
of Business: Other Location (specify): Date:
O
O
12/12/2016
O
O
ri
Ll
L.
O Wealth Details for this individual are not filled in, because they are the same as for the following person:
3D. Wealth Details (Only for parties requiring source of wealth description as indicated in Section 2)
Nature of the Individual's Business:
Primary Country of source of wealth/source of
Funds?
Primary industry of source of Wealth/Source of
Funds?
Summarize Source of Wealth:
O Business Owner O Salary/Eamings C Investment
11 Other:
II Inheritance/Gifts
Further Describe Source of Wealth /Detail the history of wealth for each of the sources: (e.g. For trusts, how did senior accumulate
wealth? For inheritance, how did family accumulate wealth?For business owners, how long in business, how many employees, level
of profitability? Indicate type of business, counties of major activities, important business partners.)
Estimated Annual Income
(S):
Estimated amount of investable asse ts(g):
Estimated Net Worth(;):
Amount of assets planned to invest with PWM(1,):
https://db forcepb .my.sal esforce.com/servlet/senflet.Integration?1 id=01N30000000D9Di ...
8/2/2018
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0031449
CONFIDENTIAL
SDNY_GM_00177633
EFTA01345231