EFTA Document EFTA01392792

ATM/Debit Service You agree that the retention or use of the ATM/Debit card constitutes acceptance of the terms and conditions of the Cardholder Agreement contained in the Terms and Conditions of Deposit Accounts. Internet Banking Service If you have selected to receive Internet Banking Services, you understand that you will be required to enter into a separate Internet Banking Services Agreement with DBTCA before you can access the IntnInet Banking Service. Acknowledgement of Receipt of Privacy Notice By signing below, you acknowledge receipt of DSTCA's Privacy Notice included in the Application Package. Non-US Individuals: Confirmation of Tax and Compliance Responsibilities. You confirm that it is your responsibility to fulfill any tax obligations and any other regulatory reporting duties applicable to you in any relevant jurisdictions that may arise in connection with assets, income or transactions in your accounqs) and your business relationship with OBTCA Non-US Organizations: Confirmation of Tax and Compliance Responsibilities. You confirm that it is your responsibility to fulfill any tax obligations and any other regulatory reporting duties applicable to it in any relevant jurisdictions that may arise in connection with assets, income or transactions in your accounUS) and your business relationship wnh DBTCA. Furthermore, you confirm that the necessary information (to the best of your knowledge and capabilities) is made available no less than annually to the relevant beneficial owner(s), settlorts), beneficiary(ies), partner(s). etc. to enable him/herr them to fulfill any respective tax obligations that may arise for him/her/ them in connection with your business relationship with DBTCA. Please complete and attach separate W-8 or W9 documentation as applicable. Terms and Conditions and Representations By signing below, you acknowledge receipt of the Terms and Conditions for Deposit Accounts attached to this Application and agree to be bound by them In addition, you agree to notify us immediately of any material change to the information provided by you on this Application. You represent and warrant that all of the information provided by you on this Application Is accurate. The Terms and Conditions for Deposit Accounts are subject to change. Acceptance You understand that this application is subject to acceptance by DMA. Joint ACCOSIT Holder's Signature •,. For ntpReinaitharayr% k.4 ;x,f 37, --WtArk. We: re 1?Zintirgs W* 47 -"t• ".?a ftt Aftiaa: 94E CP.-L-Vit: 4g4 . 0.,...`s, 4- e.s. <4 Litilthiji46WerrineWnilt.Valanlanget W.. cknftr . ItrOgligara N....ne-:?.;.'.;..a.. loate.M...'5,9......4. ..".-toe..aSttie.'*Talt.s.,QtcgA-naY ',...-il :4-mr,;".. .ta1.70.1,0.`s07-14X/m.t,..,,•I Vle;Wiffin t"StaWrx.tittrWIVWCt: 1'; W' r art t4r 7 tol itttitt.e31:.: a!i; ..t. Avid.C. ,<+!:,--: 3t- :.MAtgticit/bt*,*Se 1/40 7-*P., YEN .,,..M19,.n, 'm 4 4.:i.,0;;.te*. 1/4, , t. .. tV,..c.,4 -)r:/;.:trat-ct kt p;Statt -Vt. FACie - bcodrbie.DBICA:.•,; i . 64 -41r.'ini -. . • •17},1,-; .-'''att07 *ttt Fagatgat, t4r :c7-......t : • ii.,<azio.evew4,. 41'3%....rtt v-L., . .. '9 ..1X-ii . 4%..44'234744 4Fargn '-ilt re .:. ARMAWOWAIS-ran*Wr i'trir Mi tari ItTruestratiwi lif ften e tint. ".".- V,74CAIX,'":€ , 74-nn."1 , ...ct C•Virr a: •71-,; I-4,if tt- Datt4 9 /0, Date (h 8 b0/3 Date itercergo- .gAt:rw4-1.. 7-- • ire-vrtarsecisee4.t...;.aa). , 54%. crirMtwear,a. tv/fir, elf s`• • 41-5764-ASOINP41-47PWXW4,41 ik4"... '44 -n% ;."Pie:ff.t" '3.441 sae' t,.,..ort) w..,rtht,,,:.).-Akees:me1 *W4'41'"4.V4* a1 Mtrtas• kta a racti talgEggs tisi t ir gift, 3 13-AWM4)101 0i3959 032613 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0098060 PROT1 PROT0