Text extracted via OCR from the original document. May contain errors from the scanning process.
Beneficial Owner's Information Please complete if
owner is NOT an authorized person.
Name:
OR Entity Name:
DOB or Date of Establishment:
SSN or TIN:
Legal Address:
City:
State:
Zip/Postal Code:
Country:
Country of Citizenship:
If not U.S. (check one):
O Resident Alien
O Non-Resident Alien
Employment Status: O Employed
O Self-Employed
O Retired
O Unemployed
O Homemaker
O Student
Occupation and Position:
Employer's Name:
Employer's Address:
City:
Length of Employment:
Home Phone Number:
Business Phone Number:
Email Address:
Investment Experience
Investment Type
Experience
Annual Activity Level (Select one)
(Required)
Years of
Investing
None
No history
of any
transactions
Limited
(1-5 transactions
per year)
Moderate
(6-15
transactions
per year)
High
(Over 15
transactions
per year)
Equities
Options
Fixed Income
Mutual Funds
Exchange Traded Funds (Eifel
Real Estate Property (excluding Primary
Residence)
Variable Annuities
Alternative Investments
(Hedge Funds, Private Equity)
Structured Products
Foreign Currency
State:
Zip/Postal Code:
FINRA/Broker Dealer Affiliations (Please Answer All Questions)
Is any owner for person with a beneficial interest in the account) either (1) a senior military. governmental, or political official of any country, or (2)
closely associated with or an immediate family member of such an official? O Yes K No
Are any of the following employed by Deutsche Bank, its subsidiaries or affiliates. employed by a member firm or registered broker-dealer, or
employed by FINRA or any other self-regulatory organization? O Yes O No
Yes, please complete below)
Accounts owners?
O Yes O No
Any member of the same household as the account owner?
Any person who materially supports the account owner?
Any immediate family member of the account owner?
O Yes
O Yes
O Yes
O No
O No
O No
Any person materially supported by the account owner?
O Yes O No
If you answered YES to ANY of the above, please provide the following:
Name of Employee:
Relationship to Account Owner.
Name of Employer:
Is any owner now, or has any owner ever been, a senior corporate officer or director, or does any owner own 10% or more of any publicly-traded
company's stock? O Yes O No If YES, provide name of company:
Will anyone else be entering orders: O Yes O No
If YES, please list name(s) (additional paperwork will be required).
12-PWM-0355
011224.062212
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0044215
CONFIDENTIAL
SDNY_GM_00190399
EFTA01357588