EFTA Document EFTA01362381

KYC Print Page 7 of 19 One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summar 3A. Individual Details ;for all parties) Individual's Name: Harry Belkw - 00000467202 Date of Birth. 5 9 1956 Country of Residence! USA Country of Citizenship. USA Address of primary residence- 12 Golan Drive Monsey NY 10952 United States Has client resided outside of his/her country of nationality for 5 years or more? Oyes 2/. No Professon, Occupation: Accountant Tax ID: SSN 081-52-0727 Current Employer: HBRK Associates, Inc Position. Title. Rank Address of employer: 575 Lexington Avenue, 4th Floor Monsey NY United St tes 10022 Does the person work as senior executive of a DB-recognized regulated entity in he financial industry? (Not applicable for operating entities) oyes iii No Is the Individual a Politically Exposed Person (FEP)?(if Yes, desaibe) 0Yes 2 No To the best of your knowledge. is the individual related to an employee of the DB group?(if Family or Friendship. describe ) 0 Family 0 Friendship None To the best of your knowledge, is the individual party to a non-banking relationship with Deutsche Bank (e.g., external legal counsel, dent referral source, supplier of goods or services)?(if Yes,describe ) 0Yes 66 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. 0 r El 0 0 0 ri E 0Wealth Details for this individual are not filled in. because they are the same as for the following person: 3IL 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 Mclustry of source of Wealth/Source of Funds? Summarize Source of Wealth: 0 Business Owner 0 Salary/Earnings [investment. , i nneritance, G Its 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 wealth? For inheritance, how did family accumulate wealth?For business owners, how long in business, how many employees. level a' profitability? Indicate type of business, countries of major activities, important business partners.) https://dbforcepb.my.salesforce.com/servlet/servlet.Integration?lid IN30000000D9Di&e... 7/30/2018 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0051771 CONFIDENTIAL SDNY_ GM_ 00197955 EFTA01362381