EFTA Document EFTA01345233

KYC Print Page 13 of 34 One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summa 3A. Individual Details (for all parties) Individual's Name: - Date of Birth: Country of Residence: USA Country of Citizenship: USA Address of primary residence: Has client resided outside of country ofhis/her nationality for 5 years or more? O yes IA No Profession/Occupation: Tax ID / SSN: Current Employer: Position/lide/Ftank: Address of employer: Does t