EFTA Document EFTA01372893

7,15.2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summar 3A. Individual Details (for all parties) Individual's Name: Date of Birth: Country of Residence: Country of Citizenship: Address of primary residence: Has client resided outside of his/her country of nationality (or 5 years or more> yes # No Profession/Occupation: Tax ID / SSN: Current Employer: • Position/Title/Rank: Address of employer: 6100 Red Hook Quarter, 83