EFTA Document EFTA01387993

One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summar 30. Individual Details (for all parties) Individual's Name: Date of Birth: Country of Residence- Country of Citizens!. o Address of primary residence- Has client resdec 0.fsloe of his/her country of nationality for 5 years or morel 0 yes :*/ Nc Professor+, Occupation. N A Tax .7) SSN Current Employer: , csI:On Tit e Re-< t1 A Address of employer: N A Does the person work as senior e