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sd-10-EFTA01472154Dept. of JusticeOtherEFTA Document EFTA01472154
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Dept. of Justice
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sd-10-EFTA01472154
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Summary
Form W-9 Request for Taxpayer (Rev. August 2013) Department of the Treasury Internal Revenue Service Identification Number and Certification Name (as shown on your income tax return) Business name/disregarded entity name, if different from above Check appropriate box for federal tax classification: Individual/sole proprietor Exemptions (see instructions): C Corporation S Corporation Partnership Trust/estate Limited liability company. Enter the tax classification (C=C corporation,
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Form
W-9
Request for Taxpayer
(Rev. August 2013)
Department of the Treasury
Internal Revenue Service
Identification Number and Certification
Name (as shown on your income tax return)
Business name/disregarded entity name, if different from above
Check appropriate box for federal tax classification:
Individual/sole proprietor
Exemptions (see instructions):
C Corporation
S Corporation
Partnership
Trust/estate
Limited liability company. Enter the tax classification (C=C corporation,
S=S corporation, P=partnership) ►
Other (see instructions) ►
Address (number, street, and apt. or suite no.)
City, state, and ZIP code
List account number(s) here (optional)
Part I
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name
given on the "Name" line
to avoid backup withholding. For individuals, this is your social security
number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the Part I
instructions on page 3. For other
entities, it is your employer identification number (EIN). If you do not
have a number, see How to get a
TIN on page 3.
Note. If the account is in more than one name, see the chart on page 4 for
guidelines on whose
number to enter.
Part II
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification
number (or I am waiting for a number to be issued to me), and
2. I am not subject to backup withholding because: (a) I am exempt from
backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a
failure to report all interest or dividends, or (c) the IRS has notified me
that I am
no longer subject to backup withholding, and
3. I am a U.S. citizen or other U.S. person (defined below), and
4. The FATCA code(s) entered on this form (if any) indicating that I am
exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been
EFTA01472154
notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax
return. For real estate transactions, item 2 does not apply. For mortgage
interest paid, acquisition or abandonment of secured property, cancellation
of debt, contributions to an individual retirement arrangement (IRA), and
generally, payments other than interest and dividends, you are not required
to sign the certification, but you must provide your correct TIN. See the
instructions on page 3.
Sign
Here
Signature of
U.S. person ►
General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.
Future developments. The IRS has created a page on IRS.gov for information
about Form W-9, at www.irs.gov/w9. Information about any future developments
affecting Form W-9 (such as legislation enacted after we release it) will be
posted
on that page.
Purpose of Form
A person who is required to file an information return with the IRS must
obtain your
correct taxpayer identification number (TIN) to report, for example, income
paid to
you, payments made to you in settlement of payment card and third party
network
transactions, real estate transactions, mortgage interest you paid,
acquisition or
abandonment of secured property, cancellation of debt, or contributions you
made
to an IRA.
Use Form W-9 only if you are a U.S. person (including a resident alien), to
provide your correct TIN to the person requesting it (the requester) and,
when
applicable, to:
1. Certify that the TIN you are giving is correct (or you are waiting for a
number
to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S. exempt payee. If
applicable, you are also certifying that as a U.S. person, your allocable
share of
any partnership income from a U.S. trade or business is not subject to the
Date ►
withholding tax on foreign partners' share of effectively connected income,
and
4. Certify that FATCA code(s) entered on this form (if any) indicating that
you are
exempt from the FATCA reporting, is correct.
Note. If you are a U.S. person and a requester gives you a form other than
Form
EFTA01472155
W-9 to request your TIN, you must use the requester's form if it is
substantially
similar to this Form W-9.
Definition of a U.S. person. For federal tax purposes, you are considered a
U.S.
person if you are:
• An individual who is a U.S. citizen or U.S. resident alien,
• A partnership, corporation, company, or association created or organized
in the
United States or under the laws of the United States,
• An estate (other than a foreign estate), or
• A domestic trust (as defined in Regulations section 301.7701-7).
Special rules for partnerships. Partnerships that conduct a trade or
business in
the United States are generally required to pay a withholding tax under
section
1446 on any foreign partners' share of effectively connected taxable income
from
such business. Further, in certain cases where a Form W-9 has not been
received,
the rules under section 1446 require a partnership to presume that a partner
is a
foreign person, and pay the section 1446 withholding tax. Therefore, if you
are a
U.S. person that is a partner in a partnership conducting a trade or
business in the
United States, provide Form W-9 to the partnership to establish your U.S.
status
and avoid section 1446 withholding on your share of partnership income.
Cat. No. 10231X
Form W-9 (Rev. 8-2013)
Social security number
Employer identification number
Exempt payee code (if any)
Exemption from FATCA reporting
code (if any)
Requester's name and address (optional)
Give Form to the
requester. Do not
send to the IRS.
Print or type
See Specific Instructions on page 2.
EFTA01472156
IN WITNESS WHEREOF, the undersigned, by and through its authorized officer,
has caused this instrument to be
executed on the date listed below.
[FOR BUSINESS USERS]
Business Name
Name/Title
Signature
Date
[FOR ALL OTHER USERS]
Account Name
Name/Title
Signature
Date
DEUTSCHE BANK TRUST COMPANY AMERICAS
By
Print Name/Title
Date
By
Print Name/Title
Date
WM145781
23 Deutsche Bank Internet Banking Services Agreement for DB Private Wealth
Online Plus
010198.080714
714
EFTA01472157
Deutsche Asset
& Wealth Management
DB Private Wealth Online Plus Account Opening Application
Client Information
Client/Company Name
Online Contact Name
Title
Address
City
Phone Number
Email address
Accounts and Services (please check services for each account)
Account
Number
Balance &
Activitiy
Reporting
Account
Book
Transfer
Bill Pay
ACH
Wire
Transfer
Positive Pay
(Fees Apply)
Reconciliation
(Fess Apply)
Private Wealth ID: alpha numeric 6-16 char.
State
Zip Code
ACH Daily Limit $
Wire Transfer Daily Limit $
The ACH Daily Limit is the daily aggregate dollar amount of ACH transactions
(payments and
collections) you may send through Private Wealth Online Plus. The Wire
Transfer Daily Limit is the
daily aggregate dollar amount of wire transfers you may transmit through
Private Wealth Online Plus.
Note: By signing below, you acknowledge and agree that Deutsche Bank will
make reasonable efforts to adhere to the ACH Daily Limit and Wire Transfer
Daily Limit set forth herein, but shall have no obligation to do so.
Further, you acknowledge and agree that, in accordance with the terms of the
Internet
Banking Services Agreement, Deutsche Bank may place (and adjust) daily
dollar limits on the amount that may be transferred at any time, and from
time to
time, for any reason or for no reason.
If I have selected to receive Internet Banking Services, I understand that I
will
be required to enter a separate Internet Banking Services Agreement with
EFTA01472158
Deutsche Bank before I can access the Internet Banking Service.
Account Holder's Signature
Print Name
Date
For Office Use Only:
Primary Officer:
Secondary Officer:
Prepared by:
Approved by
Wealth Advisor:
Note: Access to DB InSight is the recommended portal to DB Private Wealth
Online
13-AWM-0135 009614.042314
EFTA01472159
For Bank Use Only
Account Number(s):
Certificate of Corporate Resolutions in favor of
Deutsche Bank Trust Company Americas
The undersigned (the "Undersigned") hereby certifies that:
I. (a) the Undersigned is the duly appointed Secretary or other officer or
director duly authorized to (i) certify as to the
corporate resolutions or consents ("Corporate Resolutions") of the board of
directors or other governing body (the
"Board") and (ii) to keep the records of
, (the "Corporation")
a corporation duly organized, in good standing, and existing under the laws
of
and
(b) the following is a true copy of the Corporate Resolutions of the Board,
duly adopted in accordance with applicable law
and governingorganizational documents with respect to the account type(s)
indicated below ("Account(s)"):
Deposit Account(s)
Investment Advisory Account(s)
(please select all that apply):
discretionary
non-discretionary
"RESOLVED, that it is desirable and in the best interests of the
Corporation, and the Corporation is authorized, to
designate Deutsche Bank Trust Company Americas (the "Bank") as depositary,
custodian or investment advisor, as
applicable, for such property as designated by the Corporation from time to
time, and to open and maintain Account(s)
with the Bank.
RESOLVED, that the Corporation be bound by the terms and conditions set
forth in any agreement or contract governing
Account(s) (the "Account Agreement(s)") and any other document relating to
products or services provided in connection
with Account(s), as revised and/or amended from time to time (collectively,
the "Agreements").
RESOLVED, that the directors, officers, employees and/or agents of the
Corporation (the "Authorized Signer(s)") whose
names, titles and signatures appear below, as amended from time to time by
the Corporation, are hereby authorized
and directed, for and on behalf of the Corporation, to open, maintain,
manage or close Account(s), to execute the
Agreements, and to exercise and direct the exercise of all duties, rights
and powers, and to take all actions necessary
or appropriate in connection with the opening, maintenance, management or
closing of Account(s) in the name of the
Corporation, pursuant to the terms and conditions specified in the
Agreements, and any applicable laws, rules and
regulations. The Bank is authorized to accept instructions from the
Authorized Signer(s) in connection with Account(s),
including, but not limited to, endorsements and deposits of negotiable
EFTA01472160
instruments, checks or other orders for the
payment of money, and instructions to deposit, withdraw, transfer, deliver
or assign assets in Account(s), sell any assets
in Account(s), including but not limited to assets listed as "held
elsewhere," buy any assets for Account(s) and retain the
services of an advisor, including the Bank, consultant or broker/dealer to
manage all or part of assets in Account(s), all on
such terms as the Authorized Signer(s) direct.
RESOLVED, that the Bank may conclusively assume that all actions taken and
instructions given by each of the
Authorized Signer(s) have been properly taken or given pursuant to authority
vested in such Authorized Signer(s) and
the Corporation shall indemnify and hold the Bank harmless from all claims,
liabilities, losses, costs, expenses (including
attorneys' fees) related to or arising from any action or inaction by any
such Authorized Signer(s).
RESOLVED, that the omission from these Corporate Resolutions of any
document, arrangement or action to be taken
in accordance with the Account(s) or the Agreements shall in no manner
derogate from the authority of the Authorized
Signer(s) to take all actions necessary, desirable, advisable or appropriate
to consummate, effectuate or carry out the
transactions contemplated by the foregoing Corporate Resolutions.
RESOLVED, that all actions taken and expenses incurred heretofore by the
Board or the Authorized Signer(s) in
connection with the Account(s) or the Agreements are hereby ratified,
approved and confirmed in all respects.
RESOLVED, that if indicated below, the Authorized Signer(s) is/are
authorized to delegate any and all of the powers
enumerated in these Corporate Resolutions in connection with the Account(s)
to such person(s) as the Authorized
Signer(s) may elect. Such delegation shall be made via the execution of the
form of Appointment of Agent(s) annexed
hereto as Exhibit A."
1
WM146028_DBTCA
019582.110314
Custody Account(s)
EFTA01472161
AUTHORIZED SIGNER(S):
If any Authorized Signer named below is an entity and not a natural person,
please attach an Authorized Signatory list.
Print Name
Authorized (select one):
Other
Check only if the above Authorized Signer is authorized to grant powers
enumerated in these Corporate Resolutions to agents.
Print Name
Authorized (select one):
Other
Check only if the above Authorized Signer is authorized to grant powers
enumerated in these Corporate Resolutions to agents.
Print Name
Authorized (select one):
Other
Check only if the above Authorized Signer is authorized to grant powers
enumerated in these Corporate Resolutions to agents.
Print Name
Authorized (select one):
Other
Check only if the above Authorized Signer is authorized to grant powers
enumerated in these Corporate Resolutions to agents.
2. The above Corporate Resolutions are in full force and effect and have not
been modified or amended since the date shown below.
3. The Bank may rely conclusively on the instructions of the Authorized
Signer(s) in every respect unless or until the Bank
receives written notification of the revocation and has had reasonable time
to act on such notice.
4. No one other than the Corporation has any interest in Account(s) opened
and maintained in the name of the Corporation.
5. The titles and names of the Authorized Signer(s) appearing above, whose
signatures appear above or on any attached
signatory list, are true, correct and genuine.
The authorities previously granted to any Authorized Signer not named herein
are hereby revoked.
In witness whereof, on the date shown below, I have subscribed my signature
and affixed the
seal of the Corporation (if required).
Signature
Print Name and Title
Date of this Certificate of Corporate Resolutions (Fill in date—this
document is not valid if date is left blank)
** If the Secretary or other authorized officer or director is one of the
Authorized Signers named
above, this Certificate of Corporate Resolutions must be confirmed below by
another officer
or director of the Corporation who is not designated an Authorized Signer
above unless the
Authorized Signers are the only officers or directors of the Corporation.
Confirmation Signature
EFTA01472162
Print Name and Title
2
WM146028_DBICA
019582.110314
Corporate Seal (if required)
If no seal is provided, the
Corporation is representing
that no seal is required.
Individually
Title
Jointly with
Signature
Individually
Title
Jointly with
Signature
Individually
Title
Jointly with
Signature
Individually
Title
Jointly with
Signature
EFTA01472163
Deutsche Asset
& Wealth Management
Deutsche Bank Trust Company Americas (DBTCA)
Business Deposit Account Opening Application
Account Title
Entity/Company Name
Mailing Address
City
Business Telephone Number
Date of Incorporation
Taxpayer ID Number (TIN)
State
Zip Code
Business Fax Number
Legal Address (if different from mailing address)
City
Client Relationship
Corporation
Foundation
Non-Profit Organization
Private Wealth Premium
Elite Business Accounts
Checking Account
Checking with Interest
(Foundation and Non-profit only)
Money Market Deposit
Cash Master Sweep Account
Target Amount
Trigger Amount
Private Wealth Premium
Banking Services
Deluxe Checkbook
Name Only
Style
Code
Name and Address
Duplicate Statement
Color
Internet Banking Services
Link to existing online relationship:
DB Private Wealth Online Plus
Name
Address
City
State
Zip Code
TM
TM
State
Zip Code
Partnership
EFTA01472164
Limited Liability Company (LLC)
Limited Liability Partnership (LLP)
Attorney Escrow Account
Landlord Master Escrow
Trust/Estates
Other Number
DBTCA Certificate of Deposit
APY
Term
DB AG NY Preferred Certificate of Deposit
Promo term
APY
Term
(DBTCA deposit account required, along with a DB AG
Preferred Terms and Conditions)
Debit Cards—Business Debit Card
WM134571 015624.072913
EFTA01472165
Notice of Customer Identification Policy
Important Information
To help the government fight the funding of terrorism and money laundering
activities, Federal law requires all financial
institutions to obtain, verify and record information that identifies each
person who establishes an account, investment or
other business relationship with a financial institution. This means that we
will ask for your name, address and other
information that will allow us to identify you We may also ask to see
identifying documents such as a certificate of
formation or good standing (legal entities) or a passport or other photo
identification (individuals).
3rd EU Notice
Governmental rules have also broadened the scope of the Bank's obligations
to aid in the fight against money laundering
and terrorist financing; these rules call for an active involvement of both
asset management firms and their clients. For new
and existing clients we currently have a legal obligation to ask our
customers questions regarding their identities, addresses,
source of funds and, if necessary, legal representatives, authorized
signatories, beneficial owners or control structures and
to collect requisite documentation to substantiate the information. Also,
enhanced anti-money laundering requirements
require that should any of the above personal or institutional information
change, our clients would be obliged to immediately
notify us of the change(s) and provide us with relevant documentation to
verify these changes.
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
Internet Banking Service.
Acknowledgement of Receipt of Privacy Notice
By signing below, you acknowledge receipt of DBTCA's Privacy Notice included
in the Application Package.
Telephone, Facsimile or E-mail Instructions
By signing below, you agree that from time to time you may give instructions
by telephone, facsimile or e-mail regarding the
above captioned account(s) (defined herein as "Verbal Instructions"). It is
understood that the risk of Verbal Instructions
being given by person or persons purported to be you is your own. Absent the
gross negligence or willful misconduct of
DBTCA, you agree to indemnify and hold harmless DBTCA for any claims,
losses, expenses, costs or attorneys' fees
resulting from DBTCA's acting upon such misunderstood and unauthorized
Verbal Instructions. You understand that DBTCA
EFTA01472166
may, but shall not be required to, seek verification of your verbal,
facsimile or e-mail instructions by call back. In case of
doubt, DBTCA may in its sole discretion refuse to execute your Verbal
Instructions or any part thereof, without incurring any
liability. DBTCA is under no obligation to execute your Verbal Instructions
to transfer funds or securities to any account(s)
without written instructions bearing your original signature.
Non-U.S. Organizations:
Confirmation of Tax and Compliance Responsibilites
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 account(s) and your
business relationship with 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), settlor(s), beneficiary(ies),
partner(s), etc., to enable him/her/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 W-9 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.
2
WM134571 15624.072913
EFTA01472167
Acceptance
You understand that this application is subject to acceptance by DBTCA.
Authorized Signer
Authorized Signer
Date
Date
For Bank Use Only
Reviewed by:
Signature
Name
Title
Date
Accepted by DBTCA:
Signature
Name
Title
Date
Account numbers:
DDA
MMDA
NOW
CD/DBAG
3
WM134571 15624.072913
EFTA01472168
Deutsche Asset
& Wealth Management
Signature Card
Deutsche Bank Trust Company Americas
Account Holder Title
Individual
Joint, with Rights
of Survivorship
Signature
Signature
Signature
Signature
Approved
Power of Attorney
Specimen Signature
* For ITF/POD/ATF See Supplemental Terms and Conditions
006678.080913
13-AWM-0359
Account Number
ITF/POD/ATF*
Joint, Tenants
in Common
Corporate
Partnership
Limited Liability
Corporation
Other:
Print Name
Print Name
Print Name
Print Name
Date
Date of Power of Attorney
Number of Signatures
Required:
EFTA01472169
Deutsche Asset
& Wealth Management
Signature Card
Deutsche Bank Trust Company Americas
Account Holder Title
Individual
Joint, with Rights
of Survivorship
Signature
Signature
Signature
Signature
Approved
Power of Attorney
Specimen Signature
* For ITF/POD/ATF See Supplemental Terms and Conditions
006678.080913
13-AWM-0359
Account Number
ITF/POD/ATF*
Joint, Tenants
in Common
Corporate
Partnership
Limited Liability
Corporation
Other:
Print Name
Print Name
Print Name
Print Name
Date
Date of Power of Attorney
Number of Signatures
Required:
66
0765963
St. Thomas, USVI 00802
6100 Red Hook Quarter, B3
3
Mort, Inc
Mort, Inc
Jeffrey Epstein
Off
Off
Off
Off
Off
Off
Off
Off
EFTA01472170
Off
Off
Off
Off
Off
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Off
Off
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Off
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Off
Off
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Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
212-971-1307
00802
U.S. Virgin Islands
EFTA01472171
St. Thomas
6100 Red Hook Quarter, B3
Mort, Inc
Yes
USVI
Mort, Inc
Jeffrey Epstein
On
Darren Indyke
On
Jeffrey Epstein
President
Off
Off
Off
Off
Off
Off
Off
Off
Yes
Off
Off
Yes
Off
Off
Off
Off
Off
Off
St. Thomas
USVI
00802
66-0765963
Mort, Inc
NAOSOD00018516-000135866
Darren Indyke
Jeffrey Epstein
Off
Off
Off
Off
1
Off
7
Off
Off
Mort, Inc
EFTA01472172
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