EFTA Document EFTA01372810

7 5 2019 1\YCi Punt One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownersh Su am a r 3A. Individual Details (for all part es) Individual's Name: Erika Kellerhals-- Date of Birth: Country of Residence: Virgin Islands, U.S. Country of Citizenship: United States Address of primary residence: Has client resided outside of his/her country of nationality for 5 years or more? Yes ,° No Profession/Occupation: Attorney Tax ID / SSN: Current Employer: Kellerhals Ferguson Kroblin PLLC Position/Title/Rank: Attorney Address of employer: 9100 Port of Sale Mall, Ste 15 St. Thomas Virgin Islands, U.S. 00802 Does the person work as senior executive of a 0B-recognized regulated entity in the financial ndustry? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities • Yes No '''' Is the individual a Politically Exposed Person (PEP)?(ff Yes, describe) N/A Yes It No To the best of your knowledge, is the individual related to an employee of the DB group?(// Familyor Mends/WA describe) N/A : Family : Fnendship II. 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 Ya,desaibe) N/A Yes 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 Placed Business: Other Location (specify): Date: Wealth Details for this individual are not filled in, because they are the same as for the following person: 3B. Wealth Details (Only for parties requiring source of wealth description as indicated ki Seddon 2) Nature of the Indrvidualts Business: Primary Country of source of wealth/source af Funds? Primary industry d source of Wealth/Source of Funds? Business Summarize Source of Wealth: Owner Salary/Earnings ):)... Investment 1...i Inheritance/Gfts Other: Further Describe did family accumulate activities, important Estimated Annual Source of Wealth /Detail the history of wealth for each of the sources: (e.g. Pa Mists, how did settler accumulate wealth? For inhentance, how wealth?For business owners, how long in business, how many employees, level of profitability? Indicate type of business, countries of major business partners.) Income($): Estimated amount of investable assets(;): Estimated Net Worth(f): Amount of assets planned to invest with PWM(S): Other Known Financial Institutions: Institution: Country: Est. Assets Under Mgt: Institution: Country: Est. Assets Under Mgt: Institution: Country: Est. Assets Under Mgt: https://dblorcepb.my.salesforce.comiserviet/servletintegration?lid=01N3000000009Dkaeid=5000e00001N08xm&ic= I SiiinkToken=Vmpf PSxNakF4 • 14/42 CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0066692 SDNY GM_00212876 EFTA01372810