EFTA Document EFTA01372818

7 5 2019 1\YCi Punt One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownersh Su ram a r 3A. Individual Details (for all parties) Individual's Name: Date of Birth: Country of Residence: Country of Citizenship: Address of primary residence: 301 East 66th St Apttew York NY 10065 United States Has client resided outside of his/her country of nationality for 5 years or more? Yes if No Profession/Occupation: N/A Tax ID / SSN: Current Employer: N/A Position/Tide/Rank: N/A Address of employer: N/A 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 i ' Yes No Is the individual a Politically Exposed Person (PEP)?(( Yes, desert e) N/A Yes I No To the best of your knowledge, is the individual related to an employee of the DB group?(/ Familyor Afendshlp, describe) N/A , Family Friendship A 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 If applicable, indicate which bank officers have met the person: Indicate where and when the client meeting(s) took place: Bank Officer Nernst) 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 In Section 2) Nature of the Individual's 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 ti 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. Fa Mists, how did settler accumulate wealth? For inhentance, how wealth7For business owners, how long in business, how many employees, level of profitalNlity? 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.comiservietiseivletIntegration?lidsOIN30000000D904e4=5000e00001NOBxm&io= SiiinkToken=vmpF P SxNak 26t42 CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0066704 SDNY GM_00212888 EFTA01372818