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sd-10-EFTA01447990Dept. of Justice

EFTA Document EFTA01447990

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Deutsche Bank Pri•dnto Wealth Manager nt Client Information Form Please complete this form for each participant of the account you are opening. This form is for informational purposes only. Personal Details Client Name/Entity Name. Jeffrey Epstein Birth Date. January 20. 1953 Social Security/Tax ID Number of Dependents: Marital Status K Single K Married K Divorced K Wdowed K Separated K Co-Habitation K Common Law Legal Address' Ate. Jeffrey Epstein Address: 6100 Red Hook

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Dept. of Justice
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sd-10-EFTA01447990
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