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sd-10-EFTA01388811Dept. of JusticeOtherEFTA Document EFTA01388811
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Dept. of Justice
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sd-10-EFTA01388811
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Summary
SY SIGNING BELOW CUENT ACKNOWLEDGES TUT: ill CU ENT RAS RECENED READ AND AGREES TO THE TERMS AND CONDITIONS OF NIS • ACCOUNT AGREEMENT, INCLUDING THE APPENDIX WHICH CONTAINS IMPORTANT INFOR/AATIONI AND (2) THE INFORMATION CONTAINED IN THIS ACCOUNT APPLICATION IS ACCURATE. CLIENT ACKNOWLEDGESTHATTHIS ACCOUNT AGREEMENT CONTAINS A PRE-DISPUTE ARBITRATION CLAUSE AT SECTION It PAGES, AND CLIENT AGREES TO TERMS (ALL ACCOUNT ADMEN ENT SO NAloRrES musr INITIALJ. *MO* THE INTERNAL REVENUE SERVICE
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EFTA DisclosureText extracted via OCR from the original document. May contain errors from the scanning process.
SY SIGNING BELOW CUENT ACKNOWLEDGES TUT: ill CU ENT RAS RECENED READ AND AGREES TO THE TERMS AND CONDITIONS OF NIS
•
ACCOUNT AGREEMENT, INCLUDING THE APPENDIX WHICH CONTAINS IMPORTANT INFOR/AATIONI AND (2) THE INFORMATION CONTAINED IN THIS
ACCOUNT APPLICATION IS ACCURATE.
CLIENT ACKNOWLEDGESTHATTHIS ACCOUNT AGREEMENT CONTAINS A PRE-DISPUTE ARBITRATION CLAUSE AT SECTION It PAGES, AND CLIENT
AGREES TO
TERMS (ALL ACCOUNT ADMEN ENT SO NAloRrES musr INITIALJ.
*MO*
THE INTERNAL REVENUE SERVICE DOES
REWIRED TO AVOID BACKUP WITHHOLDING,
PERSON AND OBTAIN A REDUCED
Imporraw IMonnellon for MUSA employee
certain Inforenaticri In connection with
related ccrnpensation. The disclosure
that you ere a fid LtIsry reesporestie tee
individual or joint account (IF THIS
CONFIRMATION OF TAX AND COMPLIANCE
Client acimoveledgea having sire remaitiEty
nmy who H connection YAW assets,
CHECK A BOX BELOW ONLY IF CLIENTS
CLIENTS SPECIFY INSTEAD
I Tenants in gammon: or
0 Community
{for m
Walt!
NOT REQUIRE CLIENT'S CONSErff TO MY PROVISION OF THIS COCUM E NT OTHER THAN THE CERTIFICATION
AND, IF APPLICABLE THE CERTIFICATION REQUIRED TO ESTABLISH CLIENTS STATUSES A NON-U.S.
RATE OF WITHHOLDING.
benefit plan dents, U.S. Depenmeit of Ls Ws regulations require °BSI to disclose to a responslae plan fiduciary
the arts, that DIM providas to a plan. to asst the Reticent .ri evaluating the reasonableness of DRSI's services and
is readable onfra at littp.thwenpronmfaxonrartiencasicnrarisafinclosuw_pcsAtmI. By signing below. you acknoMedge
the immurement ed Dears amass te the plan, you hive read the <WOW, and you understand the SaiOsure.
IS A JOINT ACCOUNT, ALL ACCOUNT OWNERS MUST SIGN,:
RESPONSIBILMES
to Mill anYtaxobligations and ens other rotatory repOrtibg duties applicable in any tan% iuredictIon a that
(notate Or tranertiOnS Si Coons accouveS) ifld business relatioruhlp vdth DRSI.
DO NOT WANT JOINT TENANTS WITH RIGHTS OF SURVIVORSHIP DR TENANTS BY THE ENTIRETIES.
t
mtples in c
Ysea ierJt a
ratans SO% 'nano h the cordmunity propeny upon death et the first swum/.
One7-a-q- ( I
Print Name o--AcRnti 'tsprtf-c-,-------
SPAN
Shamus°
Date
.
•
Prim Name
ISWEIN
VnlInatoc
Date
Prtn: Name
SSWEIN
ee.
arporation partnerrhip, trust or other andth
CONFIRMATION OF TAX AND COMPLIANCE RESPONSIBILITIES
Client aciatowledgea having solo rostonsilAny to fulfill any sex cesigatevs and cry other regulatory repertrig dunes applicable %Many relevant e'tiattealarte
tat may ma. M oonnactipn ebb assets, income or transactions In Clont's accounts) and business reladoutio with OBSI. Eurthemlore. Chad corrErns thst the
Theoesseei rforecsnon (to the best of ellent's knowledge end enwaalittles) Is made mann no I® thin annually to the relevant benetida owned.* amend*
beneficiarylia0. partner NI. et. to enable such peewits( to Mt I any tototeshre tax elefgations that may arise for such personIel In connection wan peat's
tininess reltutinenip with c444.
•
Name of Ernhy Scotian Farmer( 11C
Z
---
EnvIcgarr ID No
---.—_
*nowt or &ricer, Penn% 'ciliate. Aelneeree Part‘
Data 7 --. ( f — CR
Rint Name/Tale Jeffrey Epstein
Signature or Officer, Penner. Tnntae. Authonzed Party
Date
erre Nansatala
Signature el Mixt. Partner, Trustee. Authorend Party
WO
Print Narrienitle
13-AVA1-014S
012 taSe92•13
900/80:d
7lCr, 7 PA
xe.A
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0092574
SDNY_GM_00238758
EFTA01388811
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