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715:2019
KYC Print
One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summar
3A. Individual Details (for all pa
)
Indrvkluars Name:
Date of Birth:
Country of Rest:fence:
Country of Citizenship:
Address of primary residence:
Has client resided outside of
hrsiher country of nationality for
5 years or more'
Yes I No
Profession/Occupation:
Tax ID / SSW
Current Employer:
Position/Title/Rank:
Address of employer:
Does the person work as senior executive of a DB.recognized regulated entity in the financial
ndustry> or an entity listed on a DB-recognised exchange> (Not applicable for operating enbties
ves 1 rto
Is the individual a Politically Exposed Person (PEP)?(K Ye; desaibe)
i , yet
No
To the best of your knowledge, is the individual related to an employee of the DB grouP701 FOCI*
cr Friendsh(, dente)
.
Family
:
Fnendship
:I 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 servrcesp(f
Yeas's/bee)
Yes
If applicable, indicate which bank officers have met the person:
Indicate where and when the client metting(s) took place:
Bank Officer Name(s)
Bank Office:
Client Private
Do mole:
dent Place of
Business:
Other Location (specify):
Date:
LJ
r—,
. 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 of Funds>
Primary industry of source of Wealth/Source of Funds?
Summarize Source of Wealth:
i. • Business Owner
Salary/Earnings
Investment
Inheritance/Gifts
Other:
Further Describe Source of Wealth /Detail the history of wealth fo each of the sources: (e.g. For truss, how did settlor accumulate wealth> 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($):
Estimated amount of Investable assets(S):
Estimated Net Worth($):
Amount of assets planned to invest with PWM($):
Other Known Financial Institutions:
Institution:
Country:
Est. Assets Under Mgt:
Institution:
County:
Est. Assets Under Mgt:
Institution:
Country:
Est. Assets Under Mgt:
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CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0066758
SDNY GM_00212942
EFTA01372859