EFTA Document EFTA01345237

KYC Print Page 21 of 34 One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summa 3A. Individual Details (for all parties) Individual's Name: lean Anne Brennan Wiebracht Date of Birth: Country of Residence: USVI Country of Citizenship: USA Address of primary residence: #6-L10 Est. Nazareth St. Thomas 00802 Has client resided outside of his/her O country of nationality for 5 years or more? Yes iA No Profession/Occupation: Finance Tax ID / S