EFTA Document EFTA01356689

KYC Print Page 12 of 43 One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summa 3A. Individual Details (for all part es) Individual's Name: Harry Beller - 00000487202 Date of Birth: Country of Residence: United States Country of Citizenship: United States Address of primary residence: Monsey NY 10952 United States Has client resided outside of his/her country of nationality for 5 years or more? Li Yes g No Profession/Occupation: Accountant Tax ID / SSN: Current Employer: HBRK Associates, Inc Position/Title/Rank: Accountant Address of employer: 575 Lexington Avenue, 4th Boor Monsey NY United States 10022 Does the person work as senior executive of a DB-recognized regulated entity in the financial ndustly? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities 0 Yes g No Is the individual a Politically Exposed Person (PEP)?(if Yes, describe) N/A K Yes RI No To the best of your knowledge, is the individual related to an employee of the DB group?(if Family or Fnendship, describe) N/A K Family 0 Friendship E) 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 Yes,deScnbe) N/A 0 Yes g 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: Oient Private Domicile: Client Place of Business: Other Location (specify): Date: U 0 U r1 0 L.J Wealth Details for this individual are not filled in, because they are the same as for the following person: 38. 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: 0 Business Owner OSalary/Earnings 0 Investment 0 Inheritance/Gifts 0 Other: Further Describe Source of Wealth /Detail the history of wealth for each of the sources: (e.g. For trusts, how did settlor accumulate weakh? For inheritance, how did family accumulate wealth?For business owners, how long in business, how many employees, level of profitability? Indicate type of business, countries of major activities, important business partners.) Estimated Annual Income(;): I I Estimated amount of investable assets(;): I littps://dbforcepb.my.salesforce.com/servlet/servlet.Integration9lid=0IN30000000D9Di&eid=5000e0000 I N... 7/10/2019 CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) DB-SDNY-0042680 CONFIDENTIAL SDNY_GM_00188864 EFTA01356689